Excessive supraventricular arrhythmias linked with poor prognosis for death, stroke

Excessive supraventricular ectopic activity was associated with the development of AF in healthy patients, according to study results.

Researchers formed a population-based cohort of 678 patients from the Copenhagen Holter Study with no history of CVD, AF or stroke. They defined excessive supraventricular ectopic activity as ≥30 supraventricular ectopic complexes per hour, or as any episodes with runs ≥20 supraventricular ectopic complexes. The primary endpoint was stroke or death, with secondary endpoints of total mortality, stroke and admissions for AF. Patients were followed for a median of 6.3 years.

A total of 99 (14.6%) patients had excessive supraventricular ectopic activity, with 70 subjects experiencing ≥30 supraventricular ectopic complexes per hour and 42 experiencing runs of ≥20 supraventricular ectopic complexes per hour. Following adjustment for conventional risk factors, the researchers reported an increased risk for stroke or death in patients experiencing excessive supraventricular ectopic activity vs. those with normal activity (HR=1.64; 95% CI, 1.03-2.60). In addition, excessive supraventricular ectopic activity was associated with an increase in admissions for AF (HR=2.78; 95% CI, 1.08-6.99) and stroke (HR=2.79; 95% CI, 1.23-6.30). When used as a continuous variable, supraventricular ectopic complexes were also associated with stroke, death and admissions for AF.

“Subjects with excessive supraventricular ectopic activity may need strict risk factor modification and close follow-up for the early detection of AF,” the researchers concluded. “More research in this field is needed.”

Binici Z. Circulation. 2010;121:1904-1911.

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