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01. History of Cardiology
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08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
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32. Cardiovascular Nursing
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SUPRAVENTRICULAR ECTOPIC ACTIVITY AS A PREDICTOR OF ATRIAL FIBRILLATION - WHAT WE DIDN’T SEE 10 YEARS AGO
Session:
Painel 4 -Arritmologia 1
Speaker:
Tânia Proença
Congress:
CPC 2020
Topic:
C. Arrhythmias and Device Therapy
Theme:
04. Arrhythmias, General
Subtheme:
04.5 Arrhythmias, General – Prevention
Session Type:
Posters
FP Number:
---
Authors:
Tânia Proença; Ricardo Alves Pinto; Miguel Martins De Carvalho; Alzira Nunes; Paulo Maia Araújo; Carlos Xavier Resende; Pedro Grilo Diogo; Sofia Torres; Mariana Paiva; Ana Margarida Lebreiro; Paulo Chaves; Manuel Campelo; Carla De Sousa; Maria Júlia Maciel Barbosa
Abstract
<p><strong>Background: </strong>Atrial fibrillation (AF) induced cardioembolic stroke is one of the major causes of all ischemic strokes. Excessive supraventricular ectopic activity (ESVEA), defined by ≥ 500 premature atrial contractions per 24 hours or any sustained tachycardia episodes, is also a stroke risk factor, probably related to the risk of develop AF. Diagnosing paroxysmal atrial fibrillation (PAF) has a prognostic impact in this patients.</p> <p><strong>Methods: </strong>Patients in sinus rhythm who performed Holter between October 2009 and October 2011 in the setting of post stroke or TIA were included. These patients were followed for 8 to 10 years. Clinical and echocardiographic data were collected. Patients with AF were compared to those without AF. Statistical analysis was conducted on IBM SPSS® Statistics software.</p> <p><strong>Results: </strong>In our population of 104 patients, 54% were male, with a mean age of 63.8±14.7 years at the time of the event. In relation to the cardiovascular risk factors, 59% had hypertension, 47% dyslipidemia, 14% had diabetes, 44% were smokers or previous smokers. 67% of patients were high consumers of alcohol. 79.8% had a stroke and 21.2% a TIA. 24-hour Holter monitoring revealed ESVEA in 13.5% of the patients and PAF in 1.9%. At a follow-up of 8-10 years, new onset AF was detected in 11.5% of the patients; these patients had similar mortality comparing to those in sustained sinus rhythm (21.2% vs 16.7%, p=0.724). Alcohol intake, an established risk factor for development of AF, was associated with a non-significant increase of AF (17.3% vs 11.5%) but not related to ESVEA (16% vs 15.4%). We found a statistically significant difference between patients with and without ESVEA concerning to new onset of AF (35.7% vs 8.0%, p=0.010). ESVEA seems to be related with a higher mortality at a long follow-up, although this difference wasn’t statistically significant (35.7% vs 18.2%, p=0.132).</p> <p><strong>Conclusion: </strong>Our study showed that excessive supraventricular ectopic activity is a strong predictor of new onset AF. These findings demonstrate that Holter monitoring could be an important tool not only to diagnose AF but also to identify patients in risk of develop AF due to ESVEA.</p>
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