Excessive supraventricular ectopic activity, defined as >4 premature atrial complexes per hour, was associated with a significantly higher prevalence of paroxysmal atrial fibrillation (19.6% vs 2.8%).
Observational (n=208)
No
Absolute Event Rate: 19.6% vs 2.8%
p-value: p=<0.001
BACKGROUND: Detecting paroxysmal atrial fibrillation (PAF) in patients with cerebral ischemia is challenging. Frequent premature atrial complexes (PAC/h) and the longest supraventricular run on 24-h-Holter (SV-run(24 h)), summarised as excessive supraventricular ectopic activity (ESVEA), may help selecting patients for extended ECG-monitoring, especially in combination with echocardiographic marker LAVI/a' (left atrial volume index/late diastolic tissue Doppler velocity). METHODS: Retrospective analysis from the prospective monocentric observational trial Find-AF (ISRCTN-46104198). Patients with acute stroke or TIA were enrolled at the University Hospital Göttingen, Germany. Those with sinus rhythm at presentation received 7-day Holter-monitoring. ESVEA was quantified in one 24-hour interval free from PAF. Echocardiographic parameters were assessed prospectively. RESULTS: PAF was detected in 23/208 patients (11.1%). The median was 4 IQR 1; 22 for PAC/h and 5 IQR 0; 9 for SV-run(24 h). PAF was more prevalent in patients with ESVEA: 19.6% vs. 2.8% for PAC/h >4 vs. ≤ 4 (p5) vs. ≤ 5 beats (p = 0.003). Patients with PAF showed more supraventricular ectopic activity: 29 PAC/h IQR 9; 143 vs. 4 PAC/h 1; 14 and longest SV-run(24 h = 10) 5; 21 vs. 0 0; 8 beats (both p4 and abnormal LAVI/a' showed high PAF-rates. CONCLUSIONS: ESVEA discriminated PAF from non-PAF beyond clinical factors including LAVI/a' in patients with cerebral ischemia. Normal LAVI/a'+PAC/h ≤ 4 ruled out PAF, while prevalence was high in those with abnormal LAVI/a'+PAC/h >4.
Weber-Krüger et al. (Fri,) conducted a observational in Cerebral ischemia (acute stroke or TIA) (n=208). Excessive supraventricular ectopic activity (>4 premature atrial complexes/h) vs. ≤4 premature atrial complexes/h was evaluated on Detection of paroxysmal atrial fibrillation (p=<0.001). Excessive supraventricular ectopic activity, defined as >4 premature atrial complexes per hour, was associated with a significantly higher prevalence of paroxysmal atrial fibrillation (19.6% vs 2.8%).