Association between excessive supraventricular ectopic activity and future diagnosis of atrial fibrillation in patients with cryptogenic stroke. (19th May 2022)

• Record Type: Journal Article
• Authors: Gogos, C; Zarvalis, E; Pantelidis, P; Davora, F; Karakanas, A; Pitetzis, D; Moschovidis, V; Kantartzi, V; Stamatiadis, N; Stamos, K; Sachpekidis, V; Deretzi, G; Rudolf, J; Styliadis, I
• Is Part Of: Europace. Volume 24:Supplement 1(2022)
• Publication Date: 2022-05-19
• Subjects: Arrhythmia -- Treatment -- Periodicals; Cardiac pacing -- Periodicals; Catheter ablation -- Periodicals; Heart -- Physiology -- Periodicals; Electrophysiology -- Periodicals; 617.4120645
• DOI: 10.1093/europace/euac053.003
• Languages: English
• ISSNs: 1099-5129

Abstract

Abstract: Funding Acknowledgements: Type of funding sources: None. Background: The relationship between the excessive supraventricular ectopic activity (ESVEA) and the subclinical atrial fibrillation (AF) in patients with cryptogenic stroke is yet not fully understood. Purpose: The aim of this study is to examine the prognostic significance of ESVEA for the development of AF in those patients. Methods: The study retrospectively included 124patients, hospitalized for a cryptogenic stroke between 2014 and 2015. Twenty-four hour inpatient Holter monitoring, was used to define ESVEA as the presence of ≥20 premature atrial complexes per hour (PACs/h), along with a duration of the longest run of supraventricular tachycardia (LSVR) ≥5 seconds. After approximately 5 years of follow-up, the patients were examined for AF. Results: The remaining 111 patients(12 died and 1 was lost during follow-up) had a median age of 56 and 13 (11.71%) of them were diagnosed with AF (AF patients). The median value of CHA2DS2-VASc score was 3 and was similar for the two groups (p=0.252). Patients with AF had a significantly higher number of PACs/h and a longer duration of LSVR compared to nonAF patients (16.67 vs. 0.21, p<0.001 and 3 vs. 0 seconds, p<0.001, respectively). The existence of ESVEA was also significantly more prevalent among the AF patients (46.15%, 95% CI: 17.78% - 74.22%) compared to non-AF ones (6.1%, 95% CI: 1.3% - 10.7%, p<0.001). ROC analysis revealed the high diagnostic test accuracy of both PACs/h and LSVR for AF. The area under the curve was 97.2% (p<0.001) for PACs/h and 81.1% (p<0.001) for LSVR. Conclusions: Excessive atrial ectopy, detected with 24h inpatient Holter monitoring, is a significant indicator of future development of AF, in patients presenting originally with a cryptogenic stroke.