Are atrial high rate episodes (AHREs) a precursor to atrial fibrillation?

Ahsan A Khan, Giuseppe Boriani, Gregory Y H Lip

Research output: Contribution to journalReview articlepeer-review

6 Citations (Scopus)
223 Downloads (Pure)


Atrial high rate episodes (AHREs), also termed, subclinical atrial tachyarrhythmias or subclinical atrial fibrillation (AF) are an important cardiovascular condition. Advancement in implantable cardiac devices such as pacemakers or internal cardiac defibrillators has enabled the continuous assessment of atrial tachyarrhythmias in patients with an atrial lead. Patients with device-detected AHREs are at an elevated risk of stroke and may have unmet anticoagulation needs. While the benefits of oral anticoagulation for stroke prevention in patients with clinical AF are well recognised, it is not known whether the same risk-benefit ratio exists for anticoagulation therapy in patients with AHREs. The occurrence and significance of AHRE are increasingly acknowledged but these events are still not often acted upon in patients presenting with stroke and TIA. Additionally, patients with AHRE show a significant risk for major adverse cardiovascular events (MACE) including acute heart failure, myocardial infarction, cardiovascular hospitalisation, ventricular tachycardia/fibrillation, which is dependent on AHRE burden. In this review, we present an overview of this relatively new entity, its associated thromboembolic risk and its management implications.

Original languageEnglish
JournalClinical Research in Cardiology
Early online date14 Sept 2019
Publication statusE-pub ahead of print - 14 Sept 2019


  • Atrial high rate episodes
  • Atrial fibrillation
  • Stroke
  • Thromboembolism
  • Anticoagulation


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