Role of the monocyte-to-high-density lipoprotein ratio in predicting atrial high-rate episodes detected by cardiac implantable electronic devices

Abstract

OBJECTIVE: Technological advances have allowed cardiac implantable electronic devices (CIEDs) to detect, analyze, andstore atrial high-rate episodes (AHREs), which are surrogate for the term silent atrial fibrillation (AF). The association ofAHREs with adverse clinical events has been demonstrated in several recent studies, implying that morbidity and mortalitycan be significantly prevented by prompt recognition and intervention. Inflammation and oxidative stress are among severalmechanisms that contribute to the pathogenesis of AF. The monocyte-to-high-density lipoprotein ratio (M/H ratio) is a novelindicator of both inflammation and oxidative stress. In this study, we aimed to investigate the value of the M/H ratio for predictingAHREs detected by CIEDs.METHODS: A total of 203 patients (mean age: 57.5+9.1 years, 60.1% male) implanted with a dual pacemaker because ofsick sinus syndrome were included. Blood samples were obtained from the patients after 12 h of fasting for the analysis ofroutine biochemistry tests and the lipid panel in the morning of device implantation. At a clinical visit 6 months after CIEDimplantation, the devices were interrogated to detect the occurrence of AHREs. AHREs were defined as atrial episodes fasterthan 220 bpm and lasting longer than 5 min. The patients were divided into two groups depending on the presence of AHREsduring pacemaker interrogation: Group 1 (AHRE present) and Group 2 (AHRE absent).RESULTS: At the clinical visit 6 months after CIED implantation, 51 (25.1%) patients had at least one AHRE. The M/H ratiowas significantly higher in patients in Group 1 (11.41±1.24) than in those in Group 2 (8.17±1.02) (p