Electrocardiogram PR Interval Is a Surrogate Marker to Predict New Occurrence of Atrial Fibrillation in Patients with Frequent Premature Atrial Contractions

J Korean Med Sci. 2016 Apr;31(4):519-24. doi: 10.3346/jkms.2016.31.4.519. Epub 2016 Feb 22.

Abstract

The clinical significance of prolonged PR interval has not been evaluated in patients with frequent premature atrial contractions (PACs). We investigated whether prolonged PR interval could predict new occurrence of atrial fibrillation (AF) in patients with frequent PACs. We retrospectively analyzed 684 patients with frequent PACs (> 100 PACs/day) who performed repeated 24-hour Holter monitoring. Prolonged PR interval was defined as longer than 200 msec. Among 684 patients, 626 patients had normal PR intervals (group A) and 58 patients had prolonged PR intervals (group B). After a mean follow-up of 59.3 months, 14 patients (24.1%) in group B developed AF compared to 50 patients (8.0%) in group A (P < 0.001). Cox regression analysis showed that prolonged PR interval (hazard ratio [HR], 1.950; 95% CI, 1.029-3.698; P = 0.041), age (HR, 1.033; 95% CI, 1.006-1.060; P = 0.015), and left atrial (LA) dimension (HR, 1.061; 95% CI, 1.012-1.112; P = 0.015) were associated with AF occurrence. Prolonged PR interval, advanced age, and enlarged LA dimension are independent risk factors of AF occurrence in patients with frequent PACs.

Keywords: Atrial Fibrillation; Electrocardiography; PR Interval; Premature Atrial Contraction.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Area Under Curve
  • Atrial Fibrillation / diagnosis*
  • Atrial Fibrillation / etiology
  • Atrial Fibrillation / mortality
  • Atrial Premature Complexes / complications
  • Atrial Premature Complexes / diagnosis*
  • Electrocardiography, Ambulatory*
  • Female
  • Follow-Up Studies
  • Heart / diagnostic imaging
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Proportional Hazards Models
  • ROC Curve
  • Retrospective Studies
  • Risk Factors
  • Sex Factors