Excessive Premature Atrial Complexes and the Risk of Recurrent Stroke or Death in an Ischemic Stroke Population

Relation of premature atrial complexes with stroke and death: Systematic review and meta‐analysis

“…It has been reported that more than half of patients with cryptogenic stroke have frequent PACs (≥200 per 24 h) . In a prospective cohort study, Vinther et al observed that patients with ischemic stroke and excessive PACs carried similar risk of recurrent strokes or death compared with those with AF . Additionally, Pinho et al investigated a dose‐effect relationship between PACs and recurrence of stroke or transient ischemic attack …”

“…17 In a prospective cohort study, Vinther et al observed that patients with ischemic stroke and excessive PACs carried similar risk of recurrent strokes or death compared with those with AF. 18…”

Multiple atrial premature contractions predict stroke recurrence in patients with cryptogenic stroke and concomitant non-sustained atrial tachycardia

“…Previous investigators have defined MAPCs as frequent APCs, based on their individual study results, which represents a subjective interpretation [10][11][12]. Nevertheless, compared to patients without frequent APCs, those with frequent APCs showed poorer clinical outcomes [10][11][12]. Reportedly, in addition to the APC burden detected by Holter monitoring, APCs observed even in a single ECG tracing can affect clinical outcomes [13].…”

“…All enrolled patients underwent transthoracic echocardiography (TTE), transesophageal echocardiography, and 24-h Holter monitoring within 7 days of admission. NSAT was defined as episodes of ≥ 3 consecutive APCs with a heart rate > 100 beats/min lasting < 30 s. An APC was defined based on the following electrocardiographic parameters: a shortened RR interval (≥ 25% reduction in interval duration), the occurrence of a P wave, and QRS width < 0.12 s. The definition of the MAPC burden as frequency APCs had been varied according to their individual study results [10][11][12]. To determine the best cutoff values, which has the best performance of both sensitivity and specificity for predictors of stroke recurrence, receiver operating characteristic analysis was performed using the Youden index (sensitivity + specificity − 1).…”

Avoiding Stroke: A Continuous Monitoring Challenge

“…Premature atrial contractions (PAC), previously thought to be benign, may also increase ischemic stroke risk. Several studies have shown the relationship between excessive PACs and an increased risk of ischemic stroke [7][8][9]. A systematic review and meta-analysis based on 11 studies revealed that frequent PACs were associated with a significantly raised risk of stroke and mortality (risk ratio 1.41, 95% CI 1.25-1.60; risk ratio 2,17, 95% CI 1.13-1.41, respectively) [10].…”