Abstract
Background Atrial high-rate episodes (AHREs) detected by cardiac implantable electronic devices (CIEDs) are indicative of future clinical atrial fibrillation (AF) and stroke risk. This study aimed to investigate the prevalence of AHREs among Thai patients with CIED implantation and identify associated risk factors. Methods A retrospective observational study enrolled 278 CIED patients with AHREs lasting five minutes to 24 hours, with an average atrial rate ≥ 175 bpm, excluding known clinical AF at device implantation. Data were collected from electronic and paper medical records, and statistical analyses included Student's t-test, Mann-Whitney U test, and multivariable logistic regression. Results Of the 278 patients, 52 with pre-existing AF diagnoses were excluded. The median age was 64.86 years, with a balanced gender distribution. Hypertension was observed in 121 (53.54%) patients and diabetes in 62 (27.43%) patients. Following the designated follow-up period, 58 (20.79%) patients experienced AHREs, and eight (3.53%) developed clinical AF. Multivariable analysis confirmed diabetes as a significant risk factor for AHREs. Conclusion This study underscores the importance of monitoring AHREs for early detection of AF and stroke risk in Thai patients with CIEDs. Diabetes emerged as a significant risk factor, highlighting the need for personalized management strategies in clinical practice.