High-Sensitivity C-Reactive Protein is a Predictor of Subsequent Atrial High-Rate Episodes in Patients with Pacemakers and Preserved Ejection Fraction

• Main Authors: Min-Tsun Liao, Chun-Kai Chen, Ting-Tse Lin, Li-Ying Cheng, Hung-Wen Ting, Yen-Bin Liu
• Format: Article
• Language: English
• Published: MDPI AG 2020-11-01
• Series: Journal of Clinical Medicine
• Subjects: atrial fibrillation; pacemaker; atrial high-rate episodes; hs-CRP; inflammatory markers
• Online Access: https://www.mdpi.com/2077-0383/9/11/3677

Atrial fibrillation (AF) is associated with morbidity and mortality. Modern pacemakers can detect atrial high-rate episodes (AHREs) as a surrogate for AF. It remains controversial whether inflammation is a cause or a consequence of AF. This study investigated whether the inflammatory biomarker high-sensitivity C-reactive protein (hs-CRP) can predict subsequent AHREs. This study gathered prospective data from patients with pacemakers and a left ventricle EF ≥ 50% between 2015 and 2019. The hs-CRP and other cardiac biomarkers at baseline and device-detected AHREs, defined as atrial rate ≥ 180 bpm and duration ≥ 6 min, were determined. Cox regression analysis was used to estimate the independent predictors for AHREs. A total of 171 consecutive patients were included. During the median follow-up of 614 days, 66 patients (39%) developed subsequent AHREs. In the univariate Cox regression analysis, sick sinus syndrome (<i>p</i> = 0.005), prior AF (<i>p</i> < 0.001), mitral A velocity (<i>p</i> = 0.008), and hs-CRP (<i>p</i> = 0.013) showed significant association with the increased risk of AHREs. In the multivariate Cox regression model, hs-CRP (HR = 1.121, 95% confidence interval = 1.015–1.238, <i>p</i> = 0.024) retained its significance. Our results suggest that elevated hs-CRP could predict subsequent AHREs and that inflammation could play a role in AF pathogenesis in patients with preserved EF.