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Supraventricular arrhythmia prematurity and the risk of incident atrial fibrillation
Mashroor Khan1, Livia Colucci2, Martin Stridh2
1Department of Medicine, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
Heart Rhythm
|July 21, 2026
Summary
Premature atrial contractions and supraventricular tachycardias are common in older adults and predict future atrial fibrillation (AF). Shorter coupling intervals and increased prematurity of these arrhythmias are linked to higher AF risk.
Area of Science:
- Cardiology
- Electrophysiology
- Geriatric Medicine
Background:
- Atrial fibrillation (AF) is a prevalent condition in the elderly population.
- Premature atrial contractions (PACs) and non-sustained supraventricular tachycardias (nSVTs) are more frequent in individuals at elevated risk for developing AF.
Purpose of the Study:
- To systematically evaluate premature atrial complexes and their characteristics, including prematurity and coupling interval.
- To determine the association between individual PAC characteristics and the risk of future AF development.
Main Methods:
- Analysis of 30-second, one-lead ECG recordings from the STROKESTOP I study participants.
- Identification and characterization of PACs and nSVTs, focusing on prematurity and coupling intervals.
- Seven-year follow-up using national health registries to ascertain incident AF.
Main Results:
- Out of 6,145 participants, 740 (12.0%) developed AF over 7 years.
- Supraventricular arrhythmias were more common in those who developed AF (71.08% vs 51.21%).
- nSVTs showed the highest incident AF risk (aHR 4.70). Shorter coupling intervals were associated with increased AF risk (aHR 0.87).
Conclusions:
- Supraventricular arrhythmias are common in older adults and are associated with an increased risk of incident AF.
- Increasing prematurity of PACs is significantly associated with a higher risk of developing AF in the future.
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