Arrhythmias & electrophysiologyRandomised controlled trial
Association of atrial high-rate episodes daily burden with the risk of cardiovascular death, heart failure hospitalization, and stroke
- Analysis of patients from the B3 randomized trial
- competing-risk survival models with AHRE burden as a time-varying covariate
- CHA2DS2-VASc-adjusted
- Atrial high-rate episodes (AHREs) adjudicated
Authors' conclusion
In patients without prior AF, a daily AHRE burden ≥6 minutes was linked to a >4-fold increased risk of major CV events, mainly driven by CV death, WHFH, and progression to long-lasting AF. No such association was observed in patients with prior AF.
Study context
- Population
- Patients with sinus node dysfunction and dual-chamber pacemakers or defibrillators, followed for 3 years
- Participants
- 1,160 patients
- Comparison
- Daily AHRE burden ≥6 minutes and major cardiovascular (CV) outcomes
- Primary endpoint
- Composite of:
- CV death
- WHFH
- Stroke or TIA
- Follow-up
- 3 years
Primary result
As reported in the abstract
AHRE burden ≥6 minutesHazard ratio (95% CI)P value
patients without prior AF
4.9(2.19–10.91)
P < 0.001patients with prior AF
0.83(0.37–1.87)
P = 0.65- Primary events
- 65
- CV deaths
- 10
- Worsening heart failure hospitalization (WHFHs)
- 39
- Strokes/transient ischemic attack (TIAs)
- 16
Secondary outcomes
Occurrence of AHRE burden ≥6 minutes
- Patients with AHRE burden ≥6 minutes
- 52.5%
- Of those with AHRE burden ≥6 minutes, no prior AF
- 47.1%
Secondary end points in patients without prior AF
- CV death
- P = 0.033
- WHFH
- P < 0.001
- Long-lasting AF
- P < 0.001
- Stroke/TIA (not significant)
- P = 0.34
Original publication
Association of atrial high-rate episodes daily burden with the risk of cardiovascular death, heart failure hospitalization, and stroke. Heart Rhythm. Published 4 March 2026. doi:10.1016/j.hrthm.2026.02.048
Summarised from the published abstract; every number is checked against it