Relationship Between Left Atrial Coupling Index and Atrial High-Rate Episodes.

Abstract

Objective: This study aimed to explore the role and compare the accuracy of the left atrial coupling index (LACI) with other efficient traditional parameters for predicting atrial high-rate episodes (AHREs) in patients with cardiac implantable electronic devices (CIEDs).

Methods: This retrospective study included 203 patients with CIEDs whose echocardiographic data were recorded at least 6 months ago. The study population was divided into two groups based on whether the patients had developed AHRE. Subsequently, patients in the two groups were compared in terms of echocardiographic measurements, including left atrial functions, LACI, left atrial volume index (LAVI), left ventricle end-diastolic diameter (LVEDD), and lower left ventricle ejection fraction (LVEF).

Results: AHRE was observed in 42.8% (n = 87) of the 203 patients. Those with AHRE had a higher mean mitral E/Em, LAVI, LACI, LVEDD, and lower LVEF. LACI (OR: 1.752, 95% CI: 1.356-2.263; p < 0.001), LAVI, and age were found to be independent predictors of AHREs. A receiver operating characteristic (ROC) curve comparison demonstrated that the LACI was a better predictor of AHRE than the LAVI.

Conclusion: AHRE often progresses to atrial fibrillation, which has unfavorable consequences; therefore, predicting AHRE becomes vital. LACI, an easily accessible echocardiographic parameter, is a more robust predictor of AHRE than traditional parameters such as LAVI.