Zgodnji preddvorni ektopični utripi in upočasnjen preddvorni prevod napovedujejo preddvorno fibrilacijo

Background: Atrial fibrillation/flutter (AF/AFl) is commonly diagnosed arrhythmia, associated with increased morbidity and mortality. Therefore, we have to improve our early AF/AFl diagnostics. Several studies indicated association between conduction delay, excessive atrial ectopic beats (AEBs) and AF/AFl onset. Association with some other AEB features is less clear. Objective: To validate the role of early AEBs from Holter-ECG in relation to documented AF/AFl events. Methods and Results: We enrolled 14 consecutive patients (6 female, median 60.5 years) with documented AF/AFl during or within 6 months after Holter-ECG (AF-group). Control group consisted of 10 clinically similar consecutive patients (5 female, median 64.5 years), without any evidence of AF/AFl, but with comparable burden of AEBs. Holter-ECGs were examined with 3-channel Holter system (Schiller, Darwin2 software). 24-hour data were analyzed for number and/or burden (%) of: a) AF/AFl, b) AEBs, c) early-AEBs (coupling interval cut-off <530 ms), d) AEB pairs, triplets, runs, and e) bigeminy. In addition, P-wave duration (cut-off <130 ms), PQ, QRS, and QTc were measured. AF-group had higher burden of early-AEBs (p<0.03) and longer P-waves (p<0.05) than controls. In both groups, non-conducted and aberrantly-conducted early-AEBs, AEBs in bigeminy, pairs, triplets and runs were found, as-well-as no difference for PQ, QRS, and QTc (p=NS). The majority of 243 AF/AFl events started during day-time and in 83% with early-AEBs. Before AF onset, outbursts of early-AEBs were encountered in 58% of patients. Conclusion: A higher burden of early AES in the Holter ECG and a longer P-wave duration predict the occurrence of AF/AU.