The association between frequent premature atrial contractions and recurrent stroke in a population of ischemic stroke

Authors : Serhat GÜNLÜ, Adem AKTAN

Pages : 571-578

Doi:10.5798/dicletip.1220740

View : 14 | Download : 7

Publication Date : 2022-12-19

Article Type : Research Paper

Abstract :Objective: Premature atrial contractions insert ignore into journalissuearticles values(PACs); are a prevalent cardiac occurrence. Recent research indicates that PACs are linked to atrial fibrillation insert ignore into journalissuearticles values(AF);, ischemic stroke, and mortality. We aimed to investigate the association of PACs and the risk of recurrent stroke in patients with ischemic stroke in sinus rhythm. Methods: The study was conducted as a cross-sectional study. 24-hour standard three-lead Holter ECG monitoring was performed for seven days and analyzed. Patients were separated into two groups based on the results of Holter ECG monitoring: those with subclinical AF and those with frequent PACs. Frequent PACs were characterized as more than fourteen PACs per hour and >3 PAC runs each 24 hours. Subclinical AF was defined as atrial fibrillation, atrial flutter, or atrial tachycardia events detected by implantable or wearable cardiac devices in people without AF symptoms and in whom clinical AF was not previously detected. Results: 150 patients, consisting of 82 men insert ignore into journalissuearticles values(54.7% of the total); and 68 women insert ignore into journalissuearticles values(45.3%);, with an average age of 60.9±13.5 years, were enrolled in the research. Based on the Holter findings, patients were separated into subclinical AF insert ignore into journalissuearticles values(n=54); and frequent PACs insert ignore into journalissuearticles values(n=96);.During hospitalization, recurrent ischemic stroke was detected in 6 patients insert ignore into journalissuearticles values(11%); in the subclinical AF arm and 26 patients insert ignore into journalissuearticles values(26%); in the frequent PACs arm insert ignore into journalissuearticles values(p=0.03);. Six patients died of whom 4 died after a recurrent stroke event in the hospital. In univariate analysis age [OR: 1.03, 95%CI insert ignore into journalissuearticles values(1-1.07);, p=0.02], dyslipidemia [OR: 2.68, 95%CI insert ignore into journalissuearticles values(1.16-6.18);, p=0.021] and frequent PACs [OR: 2.97, 95%CI insert ignore into journalissuearticles values(1.13-7.76);, p=0.026] were found significant predictors of recurrent stroke. Furthermore, in multivariate logistic regression analysis only frequent PACs [OR: 2.69, 95%CI insert ignore into journalissuearticles values(1-7.17);, p=0.048] was found independent predictors of recurrent stroke. Conclusion: Frequent PACs on Holter analysis were significantly associated with recurrent ischemic stroke.
Keywords : Frequent PACs, subclinical AF, recurrent stroke, Holter ECG