Abstract MP07: Increased Risk of Death in Individuals with Premature Atrial, but not Premature Ventricular Contractions on Screening Electrocardiogram
Introduction: Premature atrial contractions (PACs) and premature ventricular contractions (PVCs) detected by long-term electrocardiographic recording have been found to be a marker of increased cardiovascular risk. However, the prognostic significance of PACs and PVCs detected by routine 12-lead screening electrocardiogram (ECG) is not well-established.
Methods: We investigated the association between PACs and PVCs detected by a single 12-lead ECG with the risks of death from any cause, cardiovascular (CVD) disease, and ischemic heart disease (IHD) in a nationally representative, community-dwelling cohort of 7642 individuals enrolled in the Third Health and Nutrition Examination Survey (NHANES III). Individuals with known coronary artery disease, congestive heart failure, paced rhythms, and atrial fibrillation were excluded.
Results: Mean age was 60 (± 14) years, 53% were women, 24% were non-Hispanic black, and 23% were Hispanics. PACs were detected in 94 (1.2%) participants while PVCs were detected in 114 (1.5%). Over a follow up period of up to 18 years, the death rates per 1000 person-years were 97, 40, and 21 for all-cause, CVD, and IHD deaths, respectively. In a demographic adjusted model, presence of PACs was associated with 50%, 78% and 151% increased risk of all-cause death, CVD death, and IHD death, respectively. After further adjustment for CVD risk factors, ECG abnormalities, concomitant comorbidities and potential confounders, these risks remained significantly high (Table). For PVCs, however, no significant associations with any type of deaths in any model were detected.
Conclusion: PACs, but not PVCs, on routine screening ECG are predictive of adverse events in community-dwelling individuals without known heart disease. Given the low cost and widespread use of 12-lead ECG, these findings warrant further investigation into mechanisms and interventions.
Author Disclosures: A.J. Shah: None. Y. Li: None. E.Z. Solman: None.
- © 2014 by American Heart Association, Inc.