Why the study?
The independent long-term prognostic significance of atrial and ventricular ectopy in low-risk populations without structural heart disease remains a subject of ongoing clinical debate.
Does high atrial or ventricular ectopic burden predict major adverse cardiovascular events in asymptomatic adults without structural heart disease?
Population
931 asymptomatic individuals without structural heart disease
Comparison
High vs low atrial and ventricular ectopic burden
Design
Cohort study
Follow-up
Median 8 years (IQR 5-11 years)
Key result
High ventricular ectopic burden was a strong independent predictor of major adverse cardiovascular events in asymptomatic adults without structural heart disease (HR 3.06; 95% CI 2.06-4.56; P<0.001).
Authors
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Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“These findings are a powerful reminder that the heart often whispers before it shouts. Subtle signs, such as frequent irregular heartbeats and complex arrhythmias, give us an early warning of future risk before symptoms occur. This could allow early intervention to alter the trajectory of disease, allowing us to move to a new era of anticipatory heart medicine.”
“Our findings suggest that risk of arrhythmia begins to increase well before typical retirement age. They strongly support the need to screen older adults for arrhythmias, beginning at around age 50, to allow for timely intervention and improved long-term outcomes.”
May inform risk stratification in asymptomatic adults; extends observational data but leaves open need for prospective validation.
Cohort (n=931)
Does high atrial or ventricular ectopic burden predict major adverse cardiovascular events in asymptomatic adults without structural heart disease?
Hazard Ratio: 3.06 (95% CI 2.06–4.56)
p-value: p=<0.001
In asymptomatic adults without structural heart disease, high ventricular ectopic burden is a strong independent predictor of long-term cardiovascular risk, whereas atrial ectopic burden is not.
Moses et al. (2026) conducted a cohort in Asymptomatic adults without structural heart disease (n=931). High ventricular ectopic burden (VEB) vs. Low ventricular ectopic burden was evaluated on Major adverse cardiovascular events (MACE) (composite of acute coronary syndrome, cerebrovascular accident, new-onset heart failure or cardiovascular mortality) (HR 3.06, 95% CI 2.06-4.56, p=<0.001). High ventricular ectopic burden was a strong independent predictor of major adverse cardiovascular events in asymptomatic adults without structural heart disease (HR 3.06; 95% CI 2.06-4.56; P<0.001).
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