High Burden of Premature Ventricular Complex Increases the Risk of New-Onset Atrial Fibrillation

BACKGROUND: High burden of premature ventricular complex (PVC) leads to increased cardiovascular mortality. A recent nationwide population-based study demonstrated that PVC is associated with an increased risk of atrial fibrillation (AF). However, the relationship between PVC burden and new-onset AF has not been investigated. The purpose of the study is to elucidate whether PVC burden is associated with new-onset AF. METHODS AND RESULTS: We designed a single-center, retrospective, large population-based cohort study to evaluate the role of PVC burden and new-onset AF in Taiwan. Patients who were AF naïve with PVC were divided into the low burden group (<1000/day) and moderate-to-high burden group (≥1000/day) based on the 24-h Holter ECG report. New-onset AF was defined as a new or first detectable event of either a persistent or paroxysmal AF. A total of 16 030 patients who were AF naïve and underwent 24-h Holter ECG monitoring were enrolled in this study, with a mean follow-up time of 973 days. A propensity score-matched analysis demonstrated that the moderate-to-high burden PVC group had a higher risk of developing new-onset AF than that of the low burden PVC group (4.91% versus 2.73%, P<0.001). Multivariate Cox regression analysis showed that moderate-to-high burden of PVC is an independent risk factor for new-onset AF. The Kaplan–Meier analysis demonstrated that patients with moderate-to-high PVC burden were associated with higher risk of new-onset AF (log-rank P<0.001). CONCLUSIONS: PVC burden is associated with new-onset AF. Patients with moderate-to-high PVC burden are at a higher risk of new-onset AF. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03877614.