Consequences of chronic frequent premature atrial contractions: Association with cardiac arrhythmias and cardiac structural changes

Research output: Contribution to journalArticle

Authors

External Institution(s)

  • Virginia Commonwealth University
  • VA Medical Center
  • University of Cincinnati Medical Center

Details

Original languageEnglish (US)
Pages (from-to)1952-1959
Number of pages8
JournalJournal of cardiovascular electrophysiology
Volume30
Issue number10
StatusPublished - Oct 1 2019
Peer-reviewedYes

Abstract

Introduction: Frequent premature ventricular contractions (PVCs) can cause cardiomyopathy (CM). Postextrasystolic potentiation (PESP) and irregularity have been in implicated as triggers of PVC-CM. Because both phenomena can also be found in premature atrial contractions (PACs), it is speculated that frequent PACs have similar consequences. Methods and results: A single-center, retrospective study included all consecutive patients undergoing a 14-day Holter monitors (November 2014 to October 2016). Patients were divided into four groups by ectopy burden group 1 (<1%) and remaining by tertiles (group 2-4). Echocardiographic and arrhythmic data were compared between PAC and PVC burdens. In addition, a translational PAC animal model was used to assess the chronic effects of frequent PACs. A total 846 patients were reviewed. In contrast to PVCs, we found no difference in left ventricular ejection fraction (LVEF), end-systolic and end-diastolic dimensions and presence of CM (LVEF <50%) between different PAC groups. Multivariate regression analysis demonstrated that only PVC burden predicted low EF (odds ratio, 1.1; confidence interval, 1.03-1.13; P =.001). While there was a weak correlation between PAC burden and supraventricular tachycardia (SVT) episodes and atrial fibrillation (AF) burden (r = 0.19; P <.001), there was no correlation between PAC burden and LVEF or CM. Finally, atrial bigeminy in our animal model did not significantly decrease LVEF after 3 months. Conclusion: PAC burden is associated with increased AF and SVT episodes. In contrast to a high PVC burden, a high PAC burden is not associated with CM. Our findings suggest that heart rate irregularity and/or PESP may play a minimal role in the pathophysiology of PVC-CM.

    Research areas

  • ambulatory Holter monitor, atrial fibrillation, cardiomyopathy, left ventricular dysfunction, premature atrial contractions, premature ventricular contractions, supraventricular tachycardia, ventricular tachycardia

Citation formats

APA

Gunda, S., Akyeampong, D., Gomez-Arroyo, J., Jovin, D. G., Kowlgi, N. G., Kaszala, K., ... Huizar, J. F. (2019). Consequences of chronic frequent premature atrial contractions: Association with cardiac arrhythmias and cardiac structural changes. Journal of cardiovascular electrophysiology, 30(10), 1952-1959. https://doi.org/10.1111/jce.14067

Harvard

Gunda, S, Akyeampong, D, Gomez-Arroyo, J, Jovin, DG, Kowlgi, NG, Kaszala, K, Tan, AY, Koneru, JN, Kron, J, Ellenbogen, KA & Huizar, JF 2019, 'Consequences of chronic frequent premature atrial contractions: Association with cardiac arrhythmias and cardiac structural changes', Journal of cardiovascular electrophysiology, vol. 30, no. 10, pp. 1952-1959. https://doi.org/10.1111/jce.14067