Arrhythmias & electrophysiology
Device-based longitudinal monitoring of premature atrial contractions before atrial fibrillation onset
Authors' conclusion
In our population of patients with CIEDs, those who developed AF had higher PAC frequencies, with a marked increase in the year before onset. A PAC burden of <31.8 PACs/d was rarely associated with future AF.
Study context
- Population
- Patients with Boston Scientific cardiovascular implantable electronic devices (CIEDs) (cardiovascular implantable electronic devices) with remote monitoringmean follow-up 5.2 years
- Participants
- 101 patients
- Exposure
- Patients who developed AF vs those who did not
- AFn = 48
- Non-AFn = 53reference
- Outcome
- PAC frequency (daily PAC count) before AF onset
Methodological details2 phases
- 2 phases
Main finding
As reported in the abstract
Daily PAC count
P < 0.0001
Observational data: associations, not effects.
Further findings
PAC threshold of 31.8 premature atrial complexes (PACs)/d for ruling out AF (ROC)
- AUC
- 0.828
- PPV
- 71%
- NPV
- 97%
PAC frequency change in the year before AF onset (AF patients, phase 2)
- Increase in PAC frequency (105.7-172.5/d; P = .04)
- 63%
- Remained elevated in the next year (P = .52)
Original publication
Device-based longitudinal monitoring of premature atrial contractions before atrial fibrillation onset. Heart Rhythm. Published 14 November 2025. doi:10.
Summarised from the published abstract; every number is checked against it