Abstract 15226: Premature Ventricular Complexes Were Not Associated With an Increased Risk of Atrial Fibrillation in Patients Without Structural Heart Disease

Background: Recent studies have suggested that patients with premature ventricular complexes (PVCs) may have a higher risk for atrial fibrillation. However, the study bases are heterogenous, and it is currently unclear whether frequent PVCs are linked to an increased risk in patients where underlying structural heart disease has been thoroughly excluded.

Research question: Do PVCs increase the risk of atrial fibrillation in patients without structural heart disease?

Aim: To analyze the risk of new-onset atrial fibrillation in PVC patients without structural heart disease.

Methods: We included PVC patients from three secondary centers in Stockholm, Sweden. The patients had no history of heart disease, normal results at exercise stress test and echocardiography, and no previous diagnosis of atrial fibrillation. For each case, four age- and sex-matched controls were obtained from the general population. Controls with previous heart disease or atrial fibrillation were excluded. We used inverse probability of treatment weighting (IPTW) to control for differences in baseline characteristics between the groups. An IPTW cause-specific hazards model was fitted using the cmprskcoxmsm package in R. Data are presented as hazard ratios (HR) with 95% confidence intervals (CI).

Results: A total of 773 PVC patients and 3128 controls were included. The median age was 59 years, and 2285 (59%) were women. Patients with PVCs had a higher incidence of malignant diseases, hypertension, and hyperlipidemia. After inverse probability of treatment weighting, baseline characteristics were well-balanced between the groups. The median follow-up time was 5.2 years (maximum 6.5 years). The risk for atrial fibrillation was higher for patients with PVCs in the crude cohort (4.3% versus 2.0%), but there was no difference between the groups in the IPTW cohort after adjusting for death as competing risk (HR 1.50, 95% CI 0.88-2.57, p=0.14).

Conclusion: PVC patients without structural heart disease did not have a higher risk of incident atrial fibrillation than age- and sex-matched controls from the general population. These results could argue against a causal relationship between PVCs and atrial fibrillation. However, more studies are needed to confirm the results.