Sagris D, Georgiopoulos G, Pateras K, et al. - An elevated risk of stroke or systemic embolism was observed in relation to single atrial high‐rate episodes (AHREs) ≥30 seconds and cumulative AHRE duration ≥24 hours.

• This systematic review and meta‐analysis involved analysis of literature documenting AHRE duration and thromboembolic risk in patients with implantable electronic devices.

• Experts analyzed 27 studies comprising 61,919 patients.

• AHREs lasting ≥30 seconds, in patients with cardiac implantable devices, led to a significant increase in the risk of stroke or systemic embolism (hazard ratio HR, 4.41), which continued to be consistent for the thresholds of 5 minutes and 6 and 24 hours.

• A marginally elevated risk of recurrent stroke or transient ischemic attack was evident in patients with previous stroke or transient ischemic attack and AHREs lasting ≥2 minutes.

• Patients with cumulative AHRE ≥24 hours exhibited a higher risk of stroke or systemic embolism than those of shorter duration or no AHRE (HR, 1.25).