Arrhythmias & electrophysiologyCohort study

Atrial Effective Refractory Periods in Patients With Frequent Premature Atrial Complexes

JACC Clin ElectrophysiolPublished

  • prospective study

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)PAC 21 · PAF 65 · persistent AF 57
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

Main finding

As reported in the abstract

AERP in the pulmonary veins (PVs)
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. JACC Clin Electrophysiol. Published 23 April 2026. doi:10.1016/j.jacep.2026.04.003

Summarised from the published abstract; every number is checked against it