2001
DOI: 10.1053/euhj.2000.2517
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The role of atrial ectopics in initiating paroxysmal atrial fibrillation

Abstract: Paroxysmal atrial fibrillation is preceded by ectopics of a fixed coupling interval in a significant proportion of patients. If, as seems likely, this is a marker of 'focally mediated' atrial fibrillation, then Holter techniques may provide a useful screening tool with which to identify patients suitable for fuller electrophysiological assessment.

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Cited by 52 publications
(20 citation statements)
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“…This is in agreement with the observations that atrial ectopic beats tend to be more frequent before the start of paroxysmal or postoperative AF [82][83][84]. However, analysis of the temporal R PAA evolution showed a sustained increasing trend was present only in a subgroup, which indicates that increasing PAA rate is not an absolute prerequisite to AF occurrence.…”
Section: Time Evolving Risk Factorssupporting
confidence: 80%
See 1 more Smart Citation
“…This is in agreement with the observations that atrial ectopic beats tend to be more frequent before the start of paroxysmal or postoperative AF [82][83][84]. However, analysis of the temporal R PAA evolution showed a sustained increasing trend was present only in a subgroup, which indicates that increasing PAA rate is not an absolute prerequisite to AF occurrence.…”
Section: Time Evolving Risk Factorssupporting
confidence: 80%
“…It had a long-tail distribution with [n PAA,min ., n PAA,median , n PAA,mean , n PAA,max. ] = [3,84,556,4539] and four patients with n PAA § 1400. It can be hypothesized that the higher risk patients might either be more prone to produce PAA or more vulnerable to PAA.…”
Section: Preoperative Risk Factor Analysis Vs Premature Atrial Activmentioning
confidence: 99%
“…16 Because most patients, particularly those with premature complexes and supraventricular arrhythmias, did not progress to permanent atrial fibrillation, a primary electric disorder may be present. 17,18 This concept is supported by the observation made during catheter ablation in patients with lone atrial fibrillation that rapidly discharging foci not only initiate but also maintain the arrhythmia; isolation of the triggers terminates ongoing fibrillation. 19,20 In animal models, atrial fibrillation can induce electrophysiological changes that tend to perpetuate arrhythmia, 5 but our findings suggest that in humans without structural heart disease, these proarrhythmic effects are insufficient for progression to the permanent form of the arrhythmia in the absence of comorbidities.…”
Section: Discussionmentioning
confidence: 58%
“…6 ACE inhibition has also been demonstrated to reduce the frequency of atrial premature beats in patients with left ventricular dysfunction, 25 and as atrial premature beats may precede the development of paroxysmal AF, their prevention may also be significant. 26 However, atrial premature beats may simply be a symptom of a sick heart rather than a 'natural course' of AF development, in exactly the same way as premature ventricular beats. In support of this, ACE inhibition has also been shown to reduce relapse rate (although nonsignificantly) in patients with AF and left ventricular dysfunction undergoing cardioversion.…”
Section: New Onset Afmentioning
confidence: 99%