Premature Atrial Contractions in the General Population

Conen, David; Adam, Martin; Roche, Frédéric; Barthélémy, Jean‐Claude; Dietrich, Denise Felber; Imboden, Medea; Künzli, Nino; Eckardstein, Arnold von; Regenass, Stephan; Hornemann, Thorsten; Rochat, Thierry; Gaspoz, Jean‐Michel; Probst‐Hensch, Nicole; Carballo, David

doi:10.1161/circulationaha.112.112300

Cited by 145 publications

(113 citation statements)

References 44 publications

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“…The average baseline APB count among our stroke patients who subsequently had AF detected was 14 times higher than in the stroke patients without AF detected, and 10-fold higher than in the general population where the median APB count/24 h is 60 (IQR, 19-228) among individuals aged ≥65 years and 62 (IQR, 29-156) among those aged ≥70 years. 18,21 These results validate and extend smaller observational stroke studies that relied on arbitrary dichotomized APB counts, and we provide a practical reference table for clinicians to estimate a patient's probability of AF for a given APB count (Table). The relationship between APB count and the probability of subclinical AF was dose-dependent and nonlinear, similar to that reported for clinical AF in a longitudinal study over a median follow-up of 13 years, 18 and there was no lower APB threshold below which AF could be excluded.…”

Section: Discussionsupporting

confidence: 71%

Atrial Premature Beats Predict Atrial Fibrillation in Cryptogenic Stroke

Gladstone

Dorian

Spring

et al. 2015

Stroke

170

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Background and Purpose— Many ischemic strokes or transient ischemic attacks are labeled cryptogenic but may have undetected atrial fibrillation (AF). We sought to identify those most likely to have subclinical AF. Methods— We prospectively studied patients with cryptogenic stroke or transient ischemic attack aged ≥55 years in sinus rhythm, without known AF, enrolled in the intervention arm of the 30 Day Event Monitoring Belt for Recording Atrial Fibrillation After a Cerebral Ischemic Event (EMBRACE) trial. Participants underwent baseline 24-hour Holter ECG poststroke; if AF was not detected, they were randomly assigned to 30-day ECG monitoring with an AF auto-detect external loop recorder. Multivariable logistic regression assessed the association between baseline variables (Holter-detected atrial premature beats [APBs], runs of atrial tachycardia, age, and left atrial enlargement) and subsequent AF detection. Results— Among 237 participants, the median baseline Holter APB count/24 h was 629 (interquartile range, 142–1973) among those who subsequently had AF detected versus 45 (interquartile range, 14–250) in those without AF ( P <0.001). APB count was the only significant predictor of AF detection by 30-day ECG ( P <0.0001), and at 90 days ( P =0.0017) and 2 years ( P =0.0027). Compared with the 16% overall 90-day AF detection rate, the probability of AF increased from <9% among patients with <100 APBs/24 h to 9% to 24% in those with 100 to 499 APBs/24 h, 25% to 37% with 500 to 999 APBs/24 h, 37% to 40% with 1000 to 1499 APBs/24 h, and 40% beyond 1500 APBs/24 h. Conclusions— Among older cryptogenic stroke or transient ischemic attack patients, the number of APBs on a routine 24-hour Holter ECG was a strong dose-dependent independent predictor of prevalent subclinical AF. Those with frequent APBs have a high probability of AF and represent ideal candidates for prolonged ECG monitoring for AF detection. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT00846924.

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Section: Discussionsupporting

confidence: 71%

Atrial Premature Beats Predict Atrial Fibrillation in Cryptogenic Stroke

Gladstone

Dorian

Spring

et al. 2015

Stroke

170

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“…[14][15][16] Contradictory reports have been published on incidence rates and characteristics of PAC in patients with symptomatic AF without previous ablative therapy compared with healthy subjects. [17][18][19] However, in population-based studies, excessive atrial ectopy has been shown to predict occurrence of new-onset AF, stroke, and death. 1 In a single study, the occurrence of PAC before and after RFA for AF was evaluated.…”

Section: Discussionmentioning

confidence: 99%

Atrial Ectopy Predicts Late Recurrence of Atrial Fibrillation After Pulmonary Vein Isolation

Gang

Nalliah

Lim

et al. 2015

Circ: Arrhythmia and Electrophysiology

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Background-Late recurrence of atrial fibrillation (AF) after radiofrequency ablation remains significant. Asymptomatic recurrence poses a difficult clinical problem as it is associated with an equally increased risk of stroke and death compared with symptomatic AF events. Meta-analyses reveal that no single preablation patient characteristic efficiently predicts these AF recurrences. This study aimed to evaluate the prognostic value of premature atrial complex (PAC) occurrence with regard to the risk of late AF recurrence after radiofrequency ablation. Methods and Results-The study cohort consisted of 124 patients with 7-day Holter recordings at 6 months post radiofrequency ablation for AF. No patients had AF recurrence before this time. Patients were followed-up every 6 months. Holter-detected PACs were defined as any supraventricular complexes occurring >30% earlier than expected.

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“…Thus, the study by Conen D. et al demonstrated no statistically significant connection between the frequency of supraventricular extrasystole and hypertension [20]. Ofoma U. et al found that ventricular and supraventricular arrhythmias occurred in 4.9 % and 5.5 % of patients respectively.…”

Section: Resultsmentioning

confidence: 95%

Features of cardiac rhythm disorders and conduction disturbances in patients with arterial hypertension

Vasylenko

2017

ZMJ

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Objective -to study features of cardiac rhythm disorders and conduction disturbances in patients with arterial hypertension.Methods of the study. Under our observation there were 110 patients with first-third degree hypertension stage II, aged 38 to 72 years (mean age -50.63 ± 1.34 years). The gender distribution of patients was as follows: 61 female (55 %) and 49 male patients (45 %). The control group comprised 30 healthy individuals, of whom 13 were male and 17 female (43 % and 57 % respectively) and whose mean age was 49.75 ± 1.83 years. Cardiac arrhythmias and conduction disorders were detected by means of Holter ECG. Statistical analysis was carried out on a personal computer, using such programs as Excel-7.0 (Microsoft Corp., USA) and Statistica ® for Windows 6.0 (StatSoft Inc., License number AXXR712D833214FAN5) through parametric and nonparametric methods.Results. Cardiac arrhythmias were found in 71 (65 %) patients with arterial hypertension and were characterized by the presence of supraventricular extrasystole in 43 (39 %) patients and paroxysmal atrial fibrillation in 10 (9 %) patients. Ventricular extrasystole and episodes of unstable ventricular tachycardia were diagnosed in 13 (12 %) and 5 (5 %) patients, respectively. In hypertensive patients supraventricular arrhythmias were detected in 2.8 times more likely (p < 0.01), and single ventricular premature beats -6.2 times more likely (p < 0.01) than the control group. It was found that in patients with moderate and severe hypertension observed a statistically significant increase in the number of single supraventricular and ventricular premature beats -21.5 % (p < 0.05) and 29.6 % (p < 0.05) respectively, compared with the subgroup of mild hypertension. Conclusions.Patients with arterial hypertension are characterized by a wide range of supraventricular and ventricular arrhythmias, namely extrasystole, atrial fibrillation, ventricular tachycardia.Особливості порушень серцевого ритму та провідності в пацієнтів з артеріальною гіпертензією А. М. ВасиленкоМета роботи -вивчити особливості порушень серцевого ритму та провідності у хворих з артеріальною гіпертензією.Матеріали та методи. Під нашим наглядом перебували 110 хворих на гіпертонічну хворобу II стадії з 1-3 ступенем артеріальної гіпертензії віком від 38 до 72 років (середній вік -50,63 ± 1,34 року). За гендерною ознакою пацієнти розподі-лились так: 61 жінка (55 %) і 49 хворих чоловіки (45 %). Контрольну групу становили 30 здорових осіб, з них 13 були чоловічої та 17 жіночої статі (43 та 57 % відповідно); середній вік -49,75 ± 1,83 року. Для виключення ішемічної хвороби серця всім пацієнтам виконували тести з фізичним навантаженням (велоергометрія, тредміл). Порушення серцевого ритму та провідності виявлялись шляхом холтерівського моніторування ЕКГ. Статистичний аналіз здійснили на персональному комп'ютері за допомогою таких програм, як Excel-7.0 (Microsoft Corp., США) та Statistica ® для Windows 6.0 (StatSoft Inc., ліцензія № AXXR712D833214FAN5) параметричними та непараметричними методами.Резуль...

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Premature Atrial Contractions in the General Population

Cited by 145 publications

References 44 publications

Atrial Premature Beats Predict Atrial Fibrillation in Cryptogenic Stroke

Atrial Premature Beats Predict Atrial Fibrillation in Cryptogenic Stroke

Atrial Ectopy Predicts Late Recurrence of Atrial Fibrillation After Pulmonary Vein Isolation

Features of cardiac rhythm disorders and conduction disturbances in patients with arterial hypertension

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