Larsen Bjørn Strøier, Aplin Mark, Nielsen Olav Wendelboe, Dominguez Vall-Lamora Maria Helena, Høst Nis Baun, Kristiansen Ole Peter, Rasmusen Hanne Kruuse, Davidsen Ulla, Karlsen Finn Michael, Højberg Søren, Sajadieh Ahmad
Department of Cardiology, Copenhagen University Hospital of Bispebjerg, Copenhagen, Denmark.
Heart Rhythm O2. 2021 Apr 22;2(3):231-238. doi: 10.1016/j.hroo.2021.04.002. eCollection 2021 Jun.
Excessive supraventricular ectopic activity (ESVEA), defined as ≥720 premature atrial contractions (PAC) per day or any runs of ≥20 PACs, has been proposed as a surrogate marker for paroxysmal atrial fibrillation (PAF).
We aimed to estimate the prognostic impact of ESVEA on the future development of PAF in consecutive patients referred to ambulatory cardiac monitoring.
The cohort consists of a population with comorbidities referred to 48-hour ambulatory electrocardiogram aged 30-98 (n = 1316) between 2009 and 2011. After exclusion of known or current atrial fibrillation (AF) (n = 527) and patients with pacemakers (n = 7), 782 patients were included, with a median follow-up of 8.1 years. Events of incident AF and death were retrieved from patient records.
Mean age was 58.6 ± 15.5 years and 56.5% were women. A total of 101 patients had ESVEA at baseline (12.9%). During follow-up, 69 (8.9%) developed incidental AF. Twenty-three patients with ESVEA developed AF (23%). Incidence rate of AF in patients with and without ESVEA was 37.1/1000 person-years and 9.1 per 1000 person-years, respectively ( < .001). ESVEA was associated with incident AF after adjustment for potential confounders in Cox regression analysis (hazard ratio [HR]: 2.39; 95% confidence interval [CI]: 1.40-4.09) and in competing risk analysis with death as competing risk (subdistribution HR: 2.35; 95% CI: 1.30-4.17).
ESVEA increases the risk of incident AF substantially in a population referred to ambulatory cardiac monitoring.
室上性异位活动过度（ESVEA）被定义为每天≥720次房性早搏（PAC）或任何≥20次PAC的连发，已被提议作为阵发性心房颤动（PAF）的替代标志物。
我们旨在评估ESVEA对连续接受动态心脏监测患者未来发生PAF的预后影响。
该队列包括2009年至2011年间年龄在30 - 98岁（n = 1316）因合并症接受48小时动态心电图检查的人群。排除已知或当前存在心房颤动（AF）（n = 527）和有起搏器的患者（n = 7）后，纳入782例患者，中位随访时间为8.1年。从患者记录中获取新发AF和死亡事件。
平均年龄为58.6±15.5岁，女性占56.5%。共有101例患者在基线时存在ESVEA（12.9%）。随访期间，69例（8.9%）发生了新发AF。23例有ESVEA的患者发生了AF（23%）。有和没有ESVEA的患者AF发病率分别为37.1/1000人年和9.1/1000人年（P <.001）。在Cox回归分析中调整潜在混杂因素后，ESVEA与新发AF相关（风险比[HR]：2.39；95%置信区间[CI]：1.40 - 4.09），在以死亡作为竞争风险的竞争风险分析中也是如此（亚分布HR：2.35；95%CI：1.30 - 4.17）。
在接受动态心脏监测的人群中，ESVEA显著增加了新发AF的风险。
