Arrhythmias & electrophysiology
Atrial Effective Refractory Periods in Patients With Frequent Premature Atrial Complexes: Implications for Atrial Fibrillation
Authors' conclusion
Isolated frequent PACs were characterized by preserved AERP in both PV and extra-PV regions. Shorter AERPs in the PVs in PAF and more widespread AERP shortening in persistent AF may reflect the transition from PACs to PAF and then progression to persistent AF.
Study context
- Population
- Patients undergoing ablation for isolated frequent premature atrial complexes (PACs), paroxysmal atrial fibrillation (PAF), or persistent atrial fibrillation (AF)
- Participants
- 143 patients
- Exposure
- Atrial effective refractory period (AERP) characteristics in patients with isolated frequent PACs and those with AF
- PACn = 21
- PAFn = 65
- Persistent AFn = 57
- Outcome
- AERP in the pulmonary veins (PVs)
Main finding
As reported in the abstract
- AERP was longest in PAC, intermediate in PAF, and shortest in persistent AF
- P < 0.001
Observational data: associations, not effects.
Further findings
AERP in extra-PV regions
Interatrial conduction time
- AERP in extra-PV regions — AERPs were similar between PAC and PAF, whereas persistent AF showed significantly shorter values
- P < 0.001
- Interatrial conduction time — comparable between PAC and PAF but prolonged in persistent AF
- P = 0.004
- PAC burden
- 36 · ± 17%
Determinants of PV and extra-PV AERP (multivariable regression)
- Arrhythmia type, standardized β (PV)
- −0.54
- Arrhythmia type, standardized β (extra-PV)
- −0.62
- P < 0.001
AERP by PAC origin (PAC patients)
- AERPs did not differ by PAC origin
Original publication
Atrial Effective Refractory Periods in Patients With Frequent Premature Atrial Complexes: Implications for Atrial Fibrillation. JACC Clin Electrophysiol. Published 23 April 2026. doi:10.
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