Division of Cardiology, Korea University College of Medicine and Korea University Anam Hospital, 73 Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea.
Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea.
Sci Rep. 2021 Jan 15;11(1):1601. doi: 10.1038/s41598-021-81229-0.
Premature ventricular contraction (PVC) and atrial fibrillation (AF) are common arrhythmias affecting 1-2% of the general population. During PVC, retrograde ventriculo-atrial activation can occur and act like an atrial ectopy. However, the clinical significance of this phenomenon is not fully understood. We aimed to elucidate whether the clinical diagnosis of PVC can increase the risk of new-onset AF. We performed a nationwide population-based analysis using the Korean National Health Insurance Service database. A total of 9,537,713 people without prior history of PVC and AF were identified. Among these people, 4135 developed PVC in 2009, and people with and without PVC were followed until 2018. People who had PVC showed an increased risk of new-onset AF as compared with people without PVC (hazard ratio [HR] = 2.705; 95% confidence interval [CI] = 2.428-3.013; p < 0.001). The risk of ischemic stroke was also significantly increased in people with PVC (HR 1.160; 95% CI 1.048-1.284; p = 0.0041). New-onset AF developed in 72 people (19.3%) among 374 people with PVC who had ischemic stroke during their follow-up. A significant interaction was observed between PVC and age with people < 65 years at greater risk of new-onset AF for having PVC. In this observational analysis, the risk of new-onset AF and ischemic stroke was increased in people with PVC. Additional evaluation to identify AF in people with PVC can be helpful.
室性期前收缩（PVC）和心房颤动（AF）是影响普通人群 1-2%的常见心律失常。在 PVC 期间，可能会发生逆行性室房激活，并表现为房性早搏。然而，这种现象的临床意义尚未完全阐明。我们旨在阐明 PVC 的临床诊断是否会增加新发 AF 的风险。我们使用韩国国家健康保险服务数据库进行了一项全国性的基于人群的分析。确定了 9537713 名没有 PVC 和 AF 既往史的人。在这些人中，2009 年有 4135 人发生 PVC，有和没有 PVC 的人一直随访到 2018 年。与没有 PVC 的人相比，有 PVC 的人新发 AF 的风险增加（风险比[HR] = 2.705；95%置信区间[CI] = 2.428-3.013；p < 0.001）。有 PVC 的人发生缺血性中风的风险也显著增加（HR 1.160；95% CI 1.048-1.284；p = 0.0041）。在随访期间发生缺血性中风的 374 名 PVC 患者中，有 72 人（19.3%）新发 AF。在 PVC 和年龄之间观察到显著的交互作用，年龄 < 65 岁的人群发生 PVC 时新发 AF 的风险更高。在这项观察性分析中，有 PVC 的人新发 AF 和缺血性中风的风险增加。对有 PVC 的人进行 AF 的额外评估可能会有所帮助。
