High Burden of Premature Ventricular Complex Increases the Risk of New‐Onset Atrial Fibrillation

BACKGROUND: High burden of premature ventricular complex (PVC) leads to increased cardiovascular mortality. A recent nationwide population‐based study demonstrated that PVC is associated with an increased risk of atrial fibrillation (AF). However, the relationship between PVC burden and new‐onset AF has not been investigated. The purpose of the study is to elucidate whether PVC burden is associated with new‐onset AF. METHODS AND RESULTS: We designed a single‐center, retrospective, large population‐based cohort study to evaluate the role of PVC burden and new‐onset AF in Taiwan. Patients who were AF naïve with PVC were divided into the low burden group (<1000/day) and moderate‐to‐high burden group (≥1000/day) based on the 24‐h Holter ECG report. New‐onset AF was defined as a new or first detectable event of either a persistent or paroxysmal AF. A total of 16 030 patients who were AF naïve and underwent 24‐h Holter ECG monitoring were enrolled in this study, with a mean follow‐up time of 973 days. A propensity score‐matched analysis demonstrated that the moderate‐to‐high burden PVC group had a higher risk of developing new‐onset AF than that of the low burden PVC group (4.91% versus 2.73%, P<0.001). Multivariate Cox regression analysis showed that moderate‐to‐high burden of PVC is an independent risk factor for new‐onset AF. The Kaplan–Meier analysis demonstrated that patients with moderate‐to‐high PVC burden were associated with higher risk of new‐onset AF (log‐rank P<0.001). CONCLUSIONS: PVC burden is associated with new‐onset AF. Patients with moderate‐to‐high PVC burden are at a higher risk of new‐onset AF. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03877614.