Premature Atrial Contractions in the General Population

• DOI: 10.1161/circulationaha.112.112300
• Publication Date: 2012-10-10T03:25:55Z
• Authors: David Conen; Martin Adam; Frederic Roche; Jean-Claude Barth...; Denise Felber Die...; Medea Imboden; Nino Künzli; Arnold von Eckard...; Stephan Regenass; Thorsten Hornemann; Thierry Rochat; Jean-Michel Gaspoz; Nicole Probst-Hensch; David Carballo
• Keywords: Male; 610 Medicine & health; Atrial Premature Complexes/diagnosis/epidemiology; 2705 Cardiology and Cardiovascular Medicine; Cohort Studies; 03 medical and health sciences; 2737 Physiology (medical); Switzerland/epidemiology; 0302 clinical medicine; Risk Factors; 540 Chemistry; Prevalence; Humans; info:eu-repo/classification/ddc/613; 10038 Institute of Clinical Chemistry; ddc:613; Aged; Aged, 80 and over; Middle Aged; 16. Peace & justice; 3. Good health; Cross-Sectional Studies; 10033 Clinic for Immunology; Electrocardiography, Ambulatory; Regression Analysis; Female; Atrial Premature Complexes; Switzerland

Background— Premature atrial contractions (PACs) are independent predictors of atrial fibrillation, stroke, and death. However, little is known about PAC frequency in the general population and its association with other cardiovascular risk factors.

Methods and Results—

We performed a cross-sectional analysis among participants of the population-based Swiss cohort Study on Air Pollution and Lung Diseases in Adults (SAPALDIA). 24-hour Holter electrocardiograms to assess PAC prevalence and frequency were performed in a random sample of 1742 participants aged ≥50 years. The median (interquartile range) number of PACs per hour was 0.8 (0.4–1.8), 1.1 (0.5–2.4), 1.4 (0.7–4.6), 2.3 (0.8–6.9), and 2.6 (1.2–6.5) among participants aged 50 to 55, 55 to 60, 60 to 65, 65 to 70, and ≥70 years, respectively ( P <0.0001). Only 18 (1.0%) participants did not have at least 1 PAC during Holter monitoring. In multivariable negative binomial regression models, PAC frequency was significantly associated with age (risk ratio [RR] per SD 1.80; P <0.0001), height (RR per SD 1.52; P <0.0001), prevalent cardiovascular disease (RR 2.40; P <0.0001), log-transformed N-terminal pro B-type natriuretic peptides (RR per SD 1.27; P <0.0001), physical activity ≥2 hours per day (RR 0.69; P =0.002), and high-density lipoprotein cholesterol (RR per SD 0.80; P =0.0002). Hypertension and body mass index were not significantly related to PAC frequency.

Conclusions— To our knowledge, this is the first study to assess risk factors for PAC frequency in the general population aged ≥50 years. PACs are common, and their frequency is independently associated with age, height, history of cardiovascular disease, natriuretic peptide levels, physical activity, and high-density lipoprotein cholesterol. The underlying mechanisms of these relationships need to be addressed in future studies.