Frequent premature atrial complexes as a predictor of atrial fibrillation: Systematic review and meta-analysis.


Journal Article

BACKGROUND:Frequent premature atrial complexes (PACs) are associated with higher morbidity and mortality. Recent studies suggest that frequent PACs are associated with new onset atrial fibrillation (AF). However, a systematic review and meta-analysis of the literature has not been done. We assessed the association between frequent PACs and new onset AF by a systematic review and a meta-analysis. METHODS:We comprehensively searched the databases of MEDLINE and EMBASE from inception to September 2017. Included studies were published cohort (prospective or retrospective) that compared new onset AF among patients with and without frequent PACs documented by Holter monitoring or 12-lead electrocardiogram. Data from each study were combined using the random-effects, generic inverse variance method of DerSimonian and Laird to calculate risk ratios and 95% confidence intervals. RESULTS:Twelve studies from 2009 to 2017 were included in this meta-analysis involving 109,689 subjects (9217frequent and 100,472 non-frequent PACs). Frequent PACs were associated with increased risk of new onset AF (pooled risk ratio = 2.76, 95% confidence interval: 2.05-3.73, p < 0.000, I2 = 90.6%). CONCLUSION:Frequent PACs are associated with up to three-fold increased risk of new onset AF. Our study suggests that frequent PACs in general population is an independent predictor of new onset AF.

Full Text

Duke Authors

Cited Authors

  • Prasitlumkum, N; Rattanawong, P; Limpruttidham, N; Kanitsoraphan, C; Sirinvaravong, N; Suppakitjanusant, P; Chongsathidkiet, P; Chung, EH

Published Date

  • September 2018

Published In

Volume / Issue

  • 51 / 5

Start / End Page

  • 760 - 767

PubMed ID

  • 30177309

Pubmed Central ID

  • 30177309

Electronic International Standard Serial Number (EISSN)

  • 1532-8430

International Standard Serial Number (ISSN)

  • 0022-0736

Digital Object Identifier (DOI)

  • 10.1016/j.jelectrocard.2018.05.012


  • eng