Excessive supraventricular ectopic activity and risk of incident atrial fibrillation in a consecutive population referred to ambulatory cardiac monitoring.

Background Excessive supraventricular ectopic activity (ESVEA) defined as ≥720 premature atrial contractions (PAC) /day or any runs of ≥20 PACs, has been proposed as a surrogate marker for paroxysmal atrial fibrillation (PAF). Objective We aimed to estimate the prognostic impact of ESVEA on the future development of PAF in consecutive patients referred to ambulatory cardiac monitoring. Methods The cohort consists of a population with comorbidities referred to 48-hour ambulatory ECG aged 30 to 98 (n = 1316) between 2009 - 2011. After exclusion of known or current AF (n = 527) and patients with pacemakers (n = 7), 782 patients were included with a median follow up of 8.1 years. Events of incident AF and death were retrieved from patient records. Results Mean age was 58.6 ± 15.5 years and 56.5% were women. 101 patients had ESVEA at baseline (12.9%). During follow-up, 69 (8.9%) developed incidental AF. 23 patients with ESVEA developed AF (23%). Incidence rate of AF in patients with and without ESVEA was 37,1 /1000 person-years and 9.1/1000 person-years, respectively (P Conclusion ESVEA increases the risk of incident atrial fibrillation substantially in a population referred to ambulatory cardiac monitoring.