Impact of arial high‐rate episodes and atrial cardiomyopathy on future stroke in patients with dual chamber permanent pacemakers.

Impact of arial high-rate episodes and atrial cardiomyopathy on future stroke in patients with dual chamber permanent pacemakers We read with great interest the article by Lu et al., on the optimal cutoff of atrial high-rate episodes (AHREs) for neurological events in patients with dual chamber permanent pacemakers (PPMs).1 The authors demonstrated that an AHRE duration of >=2 min, detected using dual-chamber PPMs, was significantly associated with neurological events in Taiwanese patients with no history of arial fibrillation (AF).1 We would like to thank Dr. Wei-Da Lu et al. for their kind interest in our article "Impact of atrial high-rate episodes on the risk of future stroke."2 In previous studies regarding AHREs, patients with a history of AF who received anticoagulant therapy were also included; however, we analyzed 348 patients with cardiac implantable electronic devices (CIEDs) who had no history of AF and anticoagulant therapy.2 Therefore, we believe that we were able to reliably assess the effect of AHRE alone on the risk of embolic stroke. Dr. Wei-Da Lu et al. analyzed a cohort from which patients with a history of AF were excluded, but included patients who had received anticoagulant therapy. [Extracted from the article]