Abstract：
UNASSIGNED: Atrial fibrillation (AF) events in cardiac implantable electronic devices (CIEDs) are temporally associated with stroke risk. This study explores temporal differences in AF burden associated with HF hospitalization risk in patients with CIEDs.
UNASSIGNED: Patients with HF events from the Optum de-identified Electronic Health Records from 2007 to 2021 and 120 days of preceding CIED-derived rhythm data from a linked manufacturer\'s data warehouse were included. AF burden ≥5.5 h/d was defined as an AF event. The AF event burden in the case period (days 1-30 immediately before the HF event) was considered temporally associated with the HF event and compared with the AF event burden in a temporally dissociated control period (days 91-120 before the HF event). The odds ratio for temporally associated HF events and the odds ratio associated with poorly rate-controlled AF (>110 bpm) were calculated.
UNASSIGNED: In total, 7257 HF events with prerequisite CIED data were included; 957 (13.2%) patients had AF events recorded only in either their case (763 [10.5%]) or control (194 [2.7%]) periods, but not both. The odds ratio for a temporally associated HF event was 3.93 (95% CI, 3.36-4.60). This was greater for an HF event with a longer stay of >3 days (odds ratio, 4.51 [95% CI, 3.57-5.68]). In patients with AF during both the control and case periods, poor AF rate control during the case period also increased HF event risk (1.78 [95% CI, 1.22-2.61]). In all, 222 of 4759 (5%) patients without AF events before their HF event had an AF event in the 10 days following.
UNASSIGNED: In a large real-world population of patients with CIED devices, AF burden was associated with HF hospitalization risk in the subsequent 30 days. The risk is increased with AF and an uncontrolled ventricular rate. Our findings support AF monitoring in CIED algorithms to prevent HF admissions.
UNASSIGNED: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04452149 and NCT04987723.
UNASSIGNED: Patients with HF events from the Optum de-identified Electronic Health Records from 2007 to 2021 and 120 days of preceding CIED-derived rhythm data from a linked manufacturer\'s data warehouse were included. AF burden ≥5.5 h/d was defined as an AF event. The AF event burden in the case period (days 1-30 immediately before the HF event) was considered temporally associated with the HF event and compared with the AF event burden in a temporally dissociated control period (days 91-120 before the HF event). The odds ratio for temporally associated HF events and the odds ratio associated with poorly rate-controlled AF (>110 bpm) were calculated.
UNASSIGNED: In total, 7257 HF events with prerequisite CIED data were included; 957 (13.2%) patients had AF events recorded only in either their case (763 [10.5%]) or control (194 [2.7%]) periods, but not both. The odds ratio for a temporally associated HF event was 3.93 (95% CI, 3.36-4.60). This was greater for an HF event with a longer stay of >3 days (odds ratio, 4.51 [95% CI, 3.57-5.68]). In patients with AF during both the control and case periods, poor AF rate control during the case period also increased HF event risk (1.78 [95% CI, 1.22-2.61]). In all, 222 of 4759 (5%) patients without AF events before their HF event had an AF event in the 10 days following.
UNASSIGNED: In a large real-world population of patients with CIED devices, AF burden was associated with HF hospitalization risk in the subsequent 30 days. The risk is increased with AF and an uncontrolled ventricular rate. Our findings support AF monitoring in CIED algorithms to prevent HF admissions.
UNASSIGNED: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04452149 and NCT04987723.
摘要：
■心脏可植入电子设备（CIED）中的心房颤动（AF）事件与中风风险在时间上相关。本研究探讨了CIED患者与HF住院风险相关的AF负担的时间差异。
■纳入了2007年至2021年Optum去识别电子健康记录中的HF事件患者，以及来自关联制造商数据仓库的120天之前CIED衍生的节律数据。房颤负荷≥5.5h/d定义为房颤事件。认为病例期(HF事件前1-30天)中的AF事件负担与HF事件在时间上相关,并与在时间上分离的对照期(HF事件前91-120天)中的AF事件负担进行比较。计算与时间相关的HF事件的比值比和与差速控制的AF（>110bpm）相关的比值比。
■总共，纳入了7257例HF事件,包括了ED数据;957例(13.2%)患者仅在其病例(763[10.5%])或对照(194[2.7%])期间记录了房颤事件。但不是两者都有。与时间相关的HF事件的比值比为3.93（95％CI，3.36-4.60）。对于长时间停留>3天的HF事件，这一点更大（优势比，4.51[95%CI，3.57-5.68]）。在控制期和病例期的房颤患者中,病例期间房颤率控制不佳也会增加HF事件风险(1.78[95%CI,1.22-2.61]).总之,在HF事件发生前无AF事件的4759例患者中,222例(5%)在随后10天发生了AF事件。
■在大量使用CIED设备的患者中，AF负担与随后30天的HF住院风险相关。房颤和不受控制的心室率增加了风险。我们的发现支持CIED算法中的AF监测以防止HF入院。
■URL：https://www。clinicaltrials.gov；唯一标识符：NCT04452149和NCT04987723。
■纳入了2007年至2021年Optum去识别电子健康记录中的HF事件患者，以及来自关联制造商数据仓库的120天之前CIED衍生的节律数据。房颤负荷≥5.5h/d定义为房颤事件。认为病例期(HF事件前1-30天)中的AF事件负担与HF事件在时间上相关,并与在时间上分离的对照期(HF事件前91-120天)中的AF事件负担进行比较。计算与时间相关的HF事件的比值比和与差速控制的AF（>110bpm）相关的比值比。
■总共，纳入了7257例HF事件,包括了ED数据;957例(13.2%)患者仅在其病例(763[10.5%])或对照(194[2.7%])期间记录了房颤事件。但不是两者都有。与时间相关的HF事件的比值比为3.93（95％CI，3.36-4.60）。对于长时间停留>3天的HF事件，这一点更大（优势比，4.51[95%CI，3.57-5.68]）。在控制期和病例期的房颤患者中,病例期间房颤率控制不佳也会增加HF事件风险(1.78[95%CI,1.22-2.61]).总之,在HF事件发生前无AF事件的4759例患者中,222例(5%)在随后10天发生了AF事件。
■在大量使用CIED设备的患者中，AF负担与随后30天的HF住院风险相关。房颤和不受控制的心室率增加了风险。我们的发现支持CIED算法中的AF监测以防止HF入院。
■URL：https://www。clinicaltrials.gov；唯一标识符：NCT04452149和NCT04987723。
