Study of retrospective analysis of atrial fibrillation risk in patients with premature ventricular contraction burden

Background: Atrial fibrillation (AF) is a common cardiac arrhythmia that significantly contributes to morbidity and mortality worldwide, primarily due to complications such as stroke and heart failure. Understanding its association with premature ventricular contractions (PVCs) is crucial, as PVCs may increase AF risk through mechanisms such as atrial remodeling. Objective: This study aims to evaluate the risk of AF in patients with significant PVC burden, utilizing 24-h Holter monitoring to identify the predictive markers of AF. Materials and Methods: This retrospective, analytical, and cross-sectional study was conducted at a tertiary care hospital in rural Pondicherry, India, from January 2023 to January 2024. Eighty-six patients aged over 18 years who underwent 24-h Holter monitoring were included, divided into two groups based on their PVC burden: 1000 PVCs in 24 h. Data on demographics, symptoms, comorbidities, and electrocardiogram findings were collected. Odds ratios (ORs) were calculated for predictive markers of AF. Results: Patients with >1000 PVCs showed significantly higher incidences of prolonged PR interval (26.7% vs. 2.4%, P < 0.01), left ventricular hypertrophy (33.3% vs. 2.4%, P < 0.01), and left atrial enlargement (55.6% vs. 7.2%, P < 0.01) compared to those with <1000 PVCs. High-PVC burden was associated with increased odds of prolonged PR interval (OR 17.67, 95% confidence interval CI 1.91–163.27), left ventricular hypertrophy (OR 12.37, 95% CI 1.30–117.26), and left atrial enlargement (OR 14.31, 95% CI 3.50–58.47). Conclusion: High-PVC burden is strongly associated with increased risk predictors of AF. Regular monitoring and timely intervention are essential for patients with high-PVC burden to prevent AF onset. Further research is needed to explore the effective strategies for reducing PVC burden and mitigating AF risk.