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

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...

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Main Authors: Po‐Tseng Lee, Mu‐Hsian Huang, Ting‐Chung Huang, Chi‐Hui Hsu, Sheng‐Hsian Lin, Ping‐Yen Liu
Format: Article
Language:English
Published: Wiley 2023-02-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Subjects:
Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.122.027674
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author Po‐Tseng Lee
Mu‐Hsian Huang
Ting‐Chung Huang
Chi‐Hui Hsu
Sheng‐Hsian Lin
Ping‐Yen Liu
author_facet Po‐Tseng Lee
Mu‐Hsian Huang
Ting‐Chung Huang
Chi‐Hui Hsu
Sheng‐Hsian Lin
Ping‐Yen Liu
author_sort Po‐Tseng Lee
collection DOAJ
description 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.
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spelling doaj.art-902f31defa834f9583f25a470e8022ff2023-03-30T03:59:11ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802023-02-0112410.1161/JAHA.122.027674High Burden of Premature Ventricular Complex Increases the Risk of New‐Onset Atrial FibrillationPo‐Tseng Lee0Mu‐Hsian Huang1Ting‐Chung Huang2Chi‐Hui Hsu3Sheng‐Hsian Lin4Ping‐Yen Liu5Institute of Clinical Medicine, College of Medicine, National Cheng Kung University Tainan TaiwanDivision of Cardiology, Department of Internal Medicine National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University Tainan TaiwanInstitute of Clinical Medicine, College of Medicine, National Cheng Kung University Tainan TaiwanInstitute of Clinical Medicine, College of Medicine, National Cheng Kung University Tainan TaiwanInstitute of Clinical Medicine, College of Medicine, National Cheng Kung University Tainan TaiwanInstitute of Clinical Medicine, College of Medicine, National Cheng Kung University Tainan TaiwanBackground 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.https://www.ahajournals.org/doi/10.1161/JAHA.122.02767424‐h Holter ECGnew‐onset atrial fibrillationpremature ventricular complexpremature ventricular complex‐induced atrial fibrillation
spellingShingle Po‐Tseng Lee
Mu‐Hsian Huang
Ting‐Chung Huang
Chi‐Hui Hsu
Sheng‐Hsian Lin
Ping‐Yen Liu
High Burden of Premature Ventricular Complex Increases the Risk of New‐Onset Atrial Fibrillation
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
24‐h Holter ECG
new‐onset atrial fibrillation
premature ventricular complex
premature ventricular complex‐induced atrial fibrillation
title High Burden of Premature Ventricular Complex Increases the Risk of New‐Onset Atrial Fibrillation
title_full High Burden of Premature Ventricular Complex Increases the Risk of New‐Onset Atrial Fibrillation
title_fullStr High Burden of Premature Ventricular Complex Increases the Risk of New‐Onset Atrial Fibrillation
title_full_unstemmed High Burden of Premature Ventricular Complex Increases the Risk of New‐Onset Atrial Fibrillation
title_short High Burden of Premature Ventricular Complex Increases the Risk of New‐Onset Atrial Fibrillation
title_sort high burden of premature ventricular complex increases the risk of new onset atrial fibrillation
topic 24‐h Holter ECG
new‐onset atrial fibrillation
premature ventricular complex
premature ventricular complex‐induced atrial fibrillation
url https://www.ahajournals.org/doi/10.1161/JAHA.122.027674
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