| Title: | Premature atrial and ventricular contractions detected on wearable-format electrocardiograms and prediction of cardiovascular events |
| Journal: | European Heart Journal - Digital Health |
| Published: | 3 Feb 2023 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/36974269/ |
| DOI: | https://doi.org/10.1093/ehjdh/ztad007 |
| URL: | https://academic.oup.com/ehjdh/article-pdf/4/2/112/49631148/ztad007.pdf |
Publication 11038
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Abstract
Aims: Wearable devices are transforming the electrocardiogram (ECG) into a ubiquitous medical test. This study assesses the association between premature ventricular and atrial contractions (PVCs and PACs) detected on wearable-format ECGs (15 s single lead) and cardiovascular outcomes in individuals without cardiovascular disease (CVD).</p>
Methods and results: Premature atrial contractions and PVCs were identified in 15 s single-lead ECGs from N = 54 016 UK Biobank participants (median age, interquartile range, age 58, 50-63 years, 54% female). Cox regression models adjusted for traditional risk factors were used to determine associations with atrial fibrillation (AF), heart failure (HF), myocardial infarction (MI), stroke, life-threatening ventricular arrhythmias (LTVAs), and mortality over a period of 11.5 (11.4-11.7) years. The strongest associations were found between PVCs (prevalence 2.2%) and HF (hazard ratio, HR, 95% confidence interval = 2.09, 1.58-2.78) and between PACs (prevalence 1.9%) and AF (HR = 2.52, 2.11-3.01), with shorter prematurity further increasing risk. Premature ventricular contractions and PACs were also associated with LTVA (P < 0.05). Associations with MI, stroke, and mortality were significant only in unadjusted models. In a separate UK Biobank sub-study sample [UKB-2, N = 29,324, age 64, 58-60 years, 54% female, follow-up 3.5 (2.6-4.8) years] used for independent validation, after adjusting for risk factors, PACs were associated with AF (HR = 1.80, 1.12-2.89) and PVCs with HF (HR = 2.32, 1.28-4.22).</p>
Conclusion: In middle-aged individuals without CVD, premature contractions identified in 15 s single-lead ECGs are strongly associated with an increased risk of AF and HF. These data warrant further investigation to assess the role of wearable ECGs for early cardiovascular risk stratification.</p>
8 Authors
- Michele Orini
- Stefan van Duijvenboden
- William J Young
- Julia Ramírez
- Aled R Jones
- Andrew Tinker
- Patricia B Munroe
- Pier D Lambiase
1 Application
| Application ID | Title |
|---|---|
| 8256 | Understanding genetic influences in the response of the cardiac electrical system to exercise |
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