Premature ventricular complexes are not independently associated with concurrent paroxysmal atrial fibrillation on mobile cardiac telemetry

Abstract

Abstract Background Premature ventricular complexes (PVCs) on 24hECG predict incident atrial fibrillation in long-term prospective studies, but whether PVCs detected on ambulatory monitoring indicate a risk of concurrent paroxysmal atrial fibrillation is unknown. Objectives To determine whether PVCs predict paroxysmal atrial fibrillation on ≤30-day ambulatory mobile cardiac telemetry (MCT). Methods US patients aged 17–100 years with 2–30 full days of ambulatory full-disclosure ECG using a mobile cardiac telemetry device, without atrial fibrillation on their first day of recording, were included. The association between PVC frequency on recording day 1 and and the outcome of atrial fibrillation ≥30 seconds during subsequent recording days was analysed using age and sex adjusted logistic regression models and restricted cubic splines, with additional adjustment for premature atrial contractions (PACs). Results The study population included 18,220 patients with a mean age 64 years; 58% were female. Median monitoring duration was 19 days (interquartile range 9–29). PVC and PAC frequency were moderatly correlated, Spearmans rho 0.359, p<0.0001. Using logistic regression analyses adjusted for age, sex and recording duration, PVCs were associated with atrial fibrillation detection (Figure 1a), but in models additionally adjusted for PAC frequency there was no remaining effect of PVC frequency on atrial fibrillation risk (Figure 1b). Conclusions A finding of PVCs, in the absence of PACs, on 24hECGs does not imply increased risk of concurrent paroxysmal atrial fibrillation detected on ≤30 day MCT. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): Hjärt-Lungfonden, Swedish Society for Medical Research