Ectopy on a Single 12‐Lead ECG, Incident Cardiac Myopathy, and Death in the Community

Abstract

BackgroundAtrial fibrillation and heart failure are 2 of the most common diseases, yet ready means to identify individuals at risk are lacking. The 12‐lead ECG is one of the most accessible tests in medicine. Our objective was to determine whether a premature atrial contraction observed on a standard 12‐lead ECG would predict atrial fibrillation and mortality and whether a premature ventricular contraction would predict heart failure and mortality.Methods and ResultsWe utilized the CHS (Cardiovascular Health) Study, which followed 5577 participants for a median of 12 years, as the primary cohort. The ARIC (Atherosclerosis Risk in Communities Study), the replication cohort, captured data from 15 792 participants over a median of 22 years. In the CHS, multivariable analyses revealed that a baseline 12‐lead ECG premature atrial contraction predicted a 60% increased risk of atrial fibrillation (hazard ratio, 1.6; 95% CI, 1.3–2.0; P<0.001) and a premature ventricular contraction predicted a 30% increased risk of heart failure (hazard ratio, 1.3; 95% CI, 1.0–1.6; P=0.021). In the negative control analyses, neither predicted incident myocardial infarction. A premature atrial contraction was associated with a 30% increased risk of death (hazard ratio, 1.3; 95% CI, 1.1–1.5; P=0.008) and a premature ventricular contraction was associated with a 20% increased risk of death (hazard ratio, 1.2; 95% CI, 1.0–1.3; P=0.044). Similarly statistically significant results for each analysis were also observed in ARIC.ConclusionsBased on a single standard ECG, a premature atrial contraction predicted incident atrial fibrillation and death and a premature ventricular contraction predicted incident heart failure and death, suggesting that this commonly used test may predict future disease.

Circulating electrolytes and the prevalence of atrial fibrillation and supraventricular ectopy: the Atherosclerosis Risk in Communities (ARIC) Study

“…PACs are associated with increased AF risk and are considered a potential endophenotype of AF. 14 The lack of association in our analysis is consistent with a small randomized study reporting no effect of oral magnesium supplementation on PAC burden. 15 As a whole, these findings suggest that magnesium may reduce AF risk through pathways other than facilitation of atrial ectopy.…”

Performance ANd ACcuracy in Electrical BioActivity Recordings (PANACEA): A high-performance, wireless, multi-instrument for potentiometric and amperometric recording of biosignals

“…ECG is a crucial diagnostic modality, which examines changes in cardiac electrical activity, e.g. rhythm disturbances [33,34]. ECG uses skin surface electrodes, which detect the electrical current spread throughout the body, caused by the cardiac activity.…”

The effect of idiopathic premature ventricular complexes on left ventricular ejection fraction

“…Premature ventricular complex can be detected in up to 70% of Holter recordings of ambulatory healthy and young adults (Von Rotz et al, ). In the literature, it was suggested that PVCs can lead to the deterioration of left ventricular (LV) function and subsequent LV dilatation which is defined as PVC induced cardiomyopathy (PVC‐CMP) (Agarwal et al, ; Nguyen et al, ; Niwano et al, ). Recent studies demonstrated that PVC‐CMP could be reversed upon the suppression of PVCs by antiarrhythmic drugs (AAD) or catheter ablation (Duffee, Shen, & Smith, ; Oomen, Dekker, & Meijer, ; Yarlagadda et al, ).…”

“…Premature ventricular complex can be detected in up to 70% of Holter recordings of ambulatory healthy and young adults (Von Rotz et al, 2017). In the literature, it was suggested that PVCs can lead to the deterioration of left ventricular (LV) function and subsequent LV dilatation which is defined as PVC induced cardiomyopathy (PVC-CMP) (Agarwal et al, 2017;Nguyen et al, 2017;Niwano et al, 2009).…”