Predictors of non-pulmonary vein ectopic beats initiating paroxysmal atrial fibrillation: implication for catheter ablation.
OBJECTIVE
The purpose of this study was to investigate the predictor of non-pulmonary vein (PV) ectopic beats initiating paroxysmal atrial fibrillation (PAF).


BACKGROUND
Non-PV ectopic beats can initiate PAF in some patients and play an important role in the recurrence of PAF after PV isolation. Information on the predictors of non-PV ectopic beats initiating PAF is unknown.


METHODS
This study included 293 patients (215 men and 78 women, age 60 +/- 14 years) with clinically documented drug-refractory PAF. Of the 94 patients with non-PV ectopic beats initiating PAF, 38 (40%) patients had superior vena cava (SVC) ectopic beats and 32 (34%) had left atrial posterior free wall (LAPFW) ectopic beats.


RESULTS
In a univariate analysis, only female gender was related to the presence of non-PV (p = 0.016) and SVC ectopic beats (p = 0.012). Right atrial enlargement (p = 0.005) and left atrial enlargement (p < 0.001) were related to the presence of LAPFW ectopic beats. In a multivariate analysis, female gender (p = 0.043; odds ratio 2.00, 95% confidence interval [CI] 1.02 to 3.92) and left atrial enlargement (p = 0.007; odds ratio 2.34, 95% CI 1.27 to 4.32) could predict the presence of non-PV ectopic beats. Subgroup analysis showed that female gender could predict the presence of SVC ectopic beats (p = 0.039; odds ratio 2.14, 95% CI 1.04 to 4.43). In contrast, left atrial enlargement could predict the presence of LAPFW ectopic beats (p = 0.002; odds ratio 3.89, 95% CI 1.62 to 9.38).


CONCLUSIONS
The location of non-PV ectopic beats initiating PAF can be predicted by both gender and left atrial enlargement.
Lee
Shih-Huang
SH
Department of Medicine, National Yang-Ming University, Taipei, Taiwan. shlee@aptg.net
Tai
Ching-Tai
CT
Hsieh
Ming-Hsiung
MH
Tsao
Hsuan-Ming
HM
Lin
Yenn-Jiang
YJ
Chang
Shih-Lin
SL
Huang
Jin-Long
JL
Lee
Kun-Tai
KT
Chen
Yi-Jen
YJ
Cheng
Jun-Jack
JJ
Chen
Shih-Ann
SA
D001281:Atrial Fibrillation / Q000209:etiology* / Q000601:surgery; D018880:Atrial Premature Complexes / Q000150:complications* / Q000601:surgery; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged