Heart failure & cardiomyopathies
Supraventricular ectopic activity predicts postoperative atrial fibrillation, new-onset atrial fibrillation, and worse survival in obstructive hypertrophic cardiomyopathy
Authors' conclusion
The incidence of POAF was 20.7%, increasing with PACs severity. Furthermore, PACs burden was positively associated with a higher incidence of adverse events. Specially, PACs >200 beats/day may best predict a higher incidence of new-onset AF and worse survival.
Study context
- Population
- Patients with obstructive hypertrophic cardiomyopathy (oHCM) undergoing surgery
- Participants
- 961 patients
- Exposure
- Patients with premature atrial contractions (PACs) >200 beats/day vs their counterparts
- Outcome
- POAF incidence
Methodological detailsconsecutively recruited, 24-h Holter monitor before surgery
- Consecutively recruited
- 24-h Holter monitor before surgery
Main finding
As reported in the abstract
Postoperative AF (POAF) incidence
20.7%
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| New-onset AF and composite endpointsPACs >200 beats/dayvs their counterpartsNew-onset AF | 3.13 (1.74–5.62) | P < 0.001 | |
| New-onset AF and composite endpointsPACs >200 beats/dayvs their counterpartsComposite endpoints | 2.00 (1.30–3.06) | P = 0.002 | |
| 0.20.5125Hazard ratio (log scale) |
POAF prediction (model including supraventricular tachycardia (SVT))
- AUC
- 0.710, 95% CI 0.670-0.750
- SVT independently associated with POAF
- Multivariable analysis
Events during follow-up · median follow-up of 2.9 years
- Deaths
- 12
- New-onset atrial fibrillation (AF)
- 60
- Composite endpoints
- 139
Correlation of new-onset AF and composite endpoints with PAC frequency
- Linear relationship (Spearman correlation)
Incremental prediction from adding PACs >200 beats/day to the multivariable model
- New-onset AF net reclassification improvement (NRI)
- 0.264
- New-onset AF integrated discrimination improvement (IDI)
- 0.033
- Composite endpoints NRI
- 0.233
- Composite endpoints IDI
- 0.014
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →