J Korean Med Sci.  2016 Apr;31(4):519-524. 10.3346/jkms.2016.31.4.519.

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

• Chun KJ
• Hwang JK
• Choi SR
• Park SJ
• On YK
• Kim JS
• Park KM

• KMID: 2363689
• DOI: http://doi.org/10.3346/jkms.2016.31.4.519

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.

Keyword

Premature Atrial Contraction; PR Interval; Electrocardiography; Atrial Fibrillation

MeSH Terms

Adult
Age Factors
Aged
Area Under Curve
Atrial Fibrillation/*diagnosis/etiology/mortality
Atrial Premature Complexes/complications/*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

Figure

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  Fig. 1 Study flow chart.

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  Fig. 2 Kaplan-Meier estimate of new-onset AF-free survival in patients with frequent PACs (A) and in patients with frequent PACs who received follow-up for more than one year (B). AF, atrial fibrillation; PAC, premature atrial contraction; HR, hazard ratio; CI, confidence interval.

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