Excess Supraventricular Ectopic Activity Predicts A-Fib, Stroke, and Death

May 04, 2010

By Michelle Rizzo

NEW YORK (Reuters Health) Apr 30 - Excessive supraventricular ectopic activity increases the risk of atrial fibrillation, stroke, and death, Danish researchers say.

Their threshold for "excessive" was 30 supraventricular ectopic complexes (SVEC) per hour or an episode of runs of more than 20 SVEC. Beyond that, the risk for atrial fibrillation and stroke was nearly tripled

"SVEC are among the most frequent arrhythmias in the population, and individuals with (excessive SVEC) constitute approximately 15% of the middle-aged or elderly population," say lead author Dr. Zeynep Binici, of Copenhagen University Hospital of Amager and Bispebjerg, and colleagues.

Healthy people often have supraventricular ectopic activity, Dr. Binici told Reuters Health by email. But if SVEC are detected routinely, doctors may want "to treat these patients with relevant risk modification and anticoagulant therapy," she added.

Dr. Binici and colleagues studied 678 healthy participants in the population-based Copenhagen Holter Study. All were between the ages of 55 and 75, with no history of cardiovascular disease, atrial fibrillation, or stroke. Each had 48-hour ambulatory ECG monitoring results.

In the May 4th issue of Circulation, the researchers report that 99 subjects (14.6%) had excessive supraventricular ectopic activity.

During a median follow-up of 76 months, 105 subjects reached the primary endpoint of death or stroke - including 29 (29%) of those with excessive supraventricular ectopic activity and 76 (13%) of those without it (p < 0.0001). The adjusted hazard ratio for stroke or death was 1.64 with excessive supraventricular ectopic activity.

Twenty-seven subjects had a stroke during follow-up, including 10 with excessive SVEC. Also, 22 developed atrial fibrillation, including 7 with excessive SVEC. The excessive ectopic activity carried adjusted hazard ratios of 2.79 for stroke and 2.73 for atrial fibrillation.

SVEC as a continuous variable was also associated with the primary end point of stroke or death, as well as hospital admission for atrial fibrillation, the authors report.

Circulation 2010;121:1904-1911.

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