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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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The presence of ectopic atrial rhythm predicts adverse cardiovascular outcomes in a large hospital-based population

Sung-Hao Huang1, Yu-Feng Hu2, Pei-Fen Chen3

  • 1Division of Cardiology, Department of Medicine, Yang-Ming University Hospital, I-Ran, Taiwan; Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.

Heart Rhythm
|February 7, 2020
PubMed

Insights

Ectopic atrial rhythm (EAR) is linked to increased cardiovascular mortality and pacemaker needs. This condition is associated with autonomic imbalance, suggesting it is a high-risk cardiovascular phenotype.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Autonomic Nervous System

Background:

  • Ectopic atrial rhythm (EAR) is a cardiac arrhythmia with unclear prognostic significance.
  • It remains uncertain whether EAR represents a high-risk cardiovascular phenotype or a benign finding.

Purpose of the Study:

  • To investigate cardiovascular outcomes in patients with EAR.
  • To explore the underlying mechanisms, including autonomic function, associated with EAR.

Main Methods:

  • A retrospective analysis of 2896 adults with EAR matched 1:5 with 14,480 patients with sinus rhythm (SR).
  • Outcomes included cardiovascular mortality and permanent pacemaker implantation.
  • Heart rate variability was assessed to evaluate autonomic function.

Main Results:

  • EAR prevalence was 1.13% and increased with age.
  • Patients with EAR exhibited significantly higher risks of cardiovascular mortality (aHR 1.93) and permanent pacemaker implantation (aHR 5.94).
  • Autonomic imbalance was indicated by reduced heart rate variability parameters in EAR patients compared to SR patients.

Conclusions:

  • Ectopic atrial rhythm is associated with increased risks of cardiovascular mortality and permanent pacemaker implantation.
  • Autonomic imbalance is a potential underlying mechanism contributing to these adverse outcomes in patients with EAR.
Abstract

Keywords:
Autonomic imbalanceCardiovascular mortalityEctopic atrial rhythmHeart rate variabilityPacemaker

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