The Burden of Ventricular Premature Complex Is Associated With Cardiovascular Mortality

Lee

Front. Cardiovasc. Med.

et al. 2022

Self Cite

AimsPremature atrial complexes (PACs) have been reported to increase the risk of adverse cardiovascular outcomes. Beta blockers at low dosages may help to reduce PAC symptoms, but it is unclear whether they can improve long-term outcomes.MethodsPatients enrolled from a Holter cohort in a medical referral center were stratified into high-burden (≥100 beats/24 h) and low-burden (<100 beats/24 h) sub-cohorts, and propensity score matching between treatment groups and non-treatment groups was conducted for each sub-cohort.ResultsIn the high-burden sub-cohort, after propensity score matching, the treatment group and non-treatment group respectively had 208 and 832 patients. The treatment group had significantly lower mortality rates than the non-treatment group [hazard ratio (HR) = 0.521, 95% confidence interval (CI) = 0.294–0.923, p = 0.025], but there was no difference in new stroke (HR = 0.830, 95% CI = 0.341–2.020, p = 0.681), and new atrial fibrillation (HR = 1.410, 95% CI = 0.867–2.292, p = 0.167) events. In the low-burden sub-cohort, after propensity score matching, there were 614 patients in the treatment group and 1,228 patients in the non-treatment group. Compared to the non-treatment group, up to 40% risk reduction in mortality was found in the treatment group (HR = 0.601, 95% CI = 0.396–0.913, p = 0.017), but no differences in new stroke (HR =0.969, 95% CI = 0.562–1.670, p = 0.910) or atrial fibrillation (HR = 1.074, 95% CI = 0.619–1.863, p = 0.800) were found.ConclusionsBeta blockers consistently decreased long-term mortality in high-burden and low-burden patients. Interestingly, this effect was not achieved through reduction of new-onset stroke or AF, and further research is warranted.

Section: Discussionsupporting

confidence: 49%

The Beneficial Effects of Beta Blockers on the Long-Term Prognosis of Patients With Premature Atrial Complexes

Lee

Front. Cardiovasc. Med.

et al. 2022

Self Cite

“…The study design was validated and described in our previous studies. 3 , 9 , 10 , 11 The study protocol and clinical data were approved by the institutional review board of National Cheng‐Kung University Hospital (approval number B‐ER‐108‐290). Informed consent was not required because the database enrolled in this study was deidentified.…”

Section: Methodsmentioning

confidence: 99%

“… 2 Moderate and high burdens of PVC also increase the risk of cardiovascular mortality compared to that of low burden of PVC. 3 , 4 In addition to cardiovascular complications, PVC is also associated with ischemic stroke. 5 Some case reports have demonstrated that PVC can trigger atrial fibrillation (AF) via intracardiac tracing.…”

mentioning

confidence: 99%

High Burden of Premature Ventricular Complex Increases the Risk of New‐Onset Atrial Fibrillation

Lee

et al. 2023

JAHA

Background High burden of premature ventricular complex (PVC) leads to increased cardiovascular mortality. A recent nationwide population‐based study demonstrated that PVC is associated with an increased risk of atrial fibrillation (AF). However, the relationship between PVC burden and new‐onset AF has not been investigated. The purpose of the study is to elucidate whether PVC burden is associated with new‐onset AF. Methods and Results We designed a single‐center, retrospective, large population‐based cohort study to evaluate the role of PVC burden and new‐onset AF in Taiwan. Patients who were AF naïve with PVC were divided into the low burden group (<1000/day) and moderate‐to‐high burden group (≥1000/day) based on the 24‐h Holter ECG report. New‐onset AF was defined as a new or first detectable event of either a persistent or paroxysmal AF. A total of 16 030 patients who were AF naïve and underwent 24‐h Holter ECG monitoring were enrolled in this study, with a mean follow‐up time of 973 days. A propensity score‐matched analysis demonstrated that the moderate‐to‐high burden PVC group had a higher risk of developing new‐onset AF than that of the low burden PVC group (4.91% versus 2.73%, P <0.001). Multivariate Cox regression analysis showed that moderate‐to‐high burden of PVC is an independent risk factor for new‐onset AF. The Kaplan–Meier analysis demonstrated that patients with moderate‐to‐high PVC burden were associated with higher risk of new‐onset AF (log‐rank P <0.001). Conclusions PVC burden is associated with new‐onset AF. Patients with moderate‐to‐high PVC burden are at a higher risk of new‐onset AF. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03877614.

Arquivos Brasileiros De Cardiologia

“…Despite having a different pathophysiological mechanism, syncope can be a marker of arrhythmic events, and be involved in an increased risk of death. 6 The study period was from January 2014 to December 2016. Patients who underwent Holter during hospitalization or after hospital discharge (up to 30 days) in a database with 4179 exams were identified.…”

Section: Methodsmentioning

confidence: 99%

“…Apesar de ter um mecanismo fisiopatológico diferente, a síncope pode ser um marcador de eventos arrítmicos, e estar envolvido em um risco aumentado de morte. 6 O período do estudo foi de janeiro de 2014 a dezembro de 2016. Foram identificados pacientes que se submeteram ao Holter durante a internação ou após a alta hospitalar (até 30 dias) em um banco de dados com 4179 exames.…”

Section: Delineamento Do Estudounclassified

Modelo Preditivo de Mortalidade por Todas as Causas em Pacientes com Insuficiência Cardíaca Usando a Variabilidade da Frequência Cardíaca

Gomes,

Benchimol-Barbosa,

Nadal

2023