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Atrial Premature Complex by ECG Finding

MedGen UID:
897113
•Concept ID:
C4082832
•
Finding
Synonyms: Atrial Premature Complex; Atrial Premature Complex by EKG Finding; Premature Atrial Complex; Premature atrial complexes

Definition

An electrocardiographic finding of an ectopic impulse originating in the atria and not specifically in the sinus node. The P wave morphology of these complexes is often different from a sinus P wave and the RR intervals preceding these complexes is also shorter than those of the regular beats. (CDISC) [from NCI]

Professional guidelines

PubMed

Intermittent isolated anterior displacement of QRS complex - Differential diagnosis.
Alboni P, Holzl A, Baggioni GF
J Electrocardiol 2023 Nov-Dec;81:224-229. Epub 2023 Oct 9 doi: 10.1016/j.jelectrocard.2023.10.003. PMID: 37837740
Cardiovascular abnormalities and its correlation with genotypes of children with osteogenesis imperfecta.
Zhao D, Liu Y, Liu J, Hu J, Zhang Q, Wang O, Jiang Y, Xia W, Xing X, Li M
Front Endocrinol (Lausanne) 2022;13:1004946. Epub 2022 Oct 20 doi: 10.3389/fendo.2022.1004946. PMID: 36339400Free PMC Article
Premature atrial and ventricular complexes in outpatients referred from a primary care facility.
Ribeiro WN, Yamada AT, Grupi CJ, da Silva GT, Mansur AJ
PLoS One 2018;13(9):e0204246. Epub 2018 Sep 20 doi: 10.1371/journal.pone.0204246. PMID: 30235300Free PMC Article

Recent clinical studies

Etiology

Arrhythmias in Williams Syndrome.
Deitch AM, Giacone HM, Chubb H, Algaze CA, Lechich KM, Collins RT
Am J Cardiol 2023 May 15;195:91-97. Epub 2023 Apr 8 doi: 10.1016/j.amjcard.2023.03.004. PMID: 37037070
Acute Effects of Coffee Consumption on Health among Ambulatory Adults.
Marcus GM, Rosenthal DG, Nah G, Vittinghoff E, Fang C, Ogomori K, Joyce S, Yilmaz D, Yang V, Kessedjian T, Wilson E, Yang M, Chang K, Wall G, Olgin JE
N Engl J Med 2023 Mar 23;388(12):1092-1100. doi: 10.1056/NEJMoa2204737. PMID: 36947466Free PMC Article
High Burden of Premature Ventricular Complex Increases the Risk of New-Onset Atrial Fibrillation.
Lee PT, Huang MH, Huang TC, Hsu CH, Lin SH, Liu PY
J Am Heart Assoc 2023 Feb 21;12(4):e027674. Epub 2023 Feb 15 doi: 10.1161/JAHA.122.027674. PMID: 36789835Free PMC Article
Premature Atrial Contractions and Their Association with Stroke Features and Outcome.
Liu HY, Wu JY, Chung CP, Lee IH, Lin CJ, Lin CJ, Hsu LC, Chao TF
J Stroke Cerebrovasc Dis 2020 Oct;29(10):105118. Epub 2020 Jul 11 doi: 10.1016/j.jstrokecerebrovasdis.2020.105118. PMID: 32912526
Differentiating junctional tachycardia and atrioventricular node re-entry tachycardia based on response to atrial extrastimulus pacing.
Padanilam BJ, Manfredi JA, Steinberg LA, Olson JA, Fogel RI, Prystowsky EN
J Am Coll Cardiol 2008 Nov 18;52(21):1711-7. doi: 10.1016/j.jacc.2008.08.030. PMID: 19007691

Diagnosis

The Electrocardiographic Footprints of Atrial Ectopy.
Mond HG, Haqqani HM
Heart Lung Circ 2019 Oct;28(10):1463-1471. Epub 2019 Apr 26 doi: 10.1016/j.hlc.2019.03.005. PMID: 31076238
Ectopic Beats: Insights from Timing and Morphology.
Bagliani G, Della Rocca DG, De Ponti R, Capucci A, Padeletti M, Natale A
Card Electrophysiol Clin 2018 Jun;10(2):257-275. doi: 10.1016/j.ccep.2018.02.013. PMID: 29784483
Fetal and Neonatal Arrhythmias.
Jaeggi E, Öhman A
Clin Perinatol 2016 Mar;43(1):99-112. doi: 10.1016/j.clp.2015.11.007. PMID: 26876124
Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins.
Haïssaguerre M, Jaïs P, Shah DC, Takahashi A, Hocini M, Quiniou G, Garrigue S, Le Mouroux A, Le Métayer P, Clémenty J
N Engl J Med 1998 Sep 3;339(10):659-66. doi: 10.1056/NEJM199809033391003. PMID: 9725923
Mitral valve regurgitation.
O'Rourke RA, Crawford MH
Curr Probl Cardiol 1984 May;9(2):1-52. doi: 10.1016/0146-2806(84)90021-5. PMID: 6375982

Therapy

Acute Effects of Coffee Consumption on Health among Ambulatory Adults.
Marcus GM, Rosenthal DG, Nah G, Vittinghoff E, Fang C, Ogomori K, Joyce S, Yilmaz D, Yang V, Kessedjian T, Wilson E, Yang M, Chang K, Wall G, Olgin JE
N Engl J Med 2023 Mar 23;388(12):1092-1100. doi: 10.1056/NEJMoa2204737. PMID: 36947466Free PMC Article
Fetal and Neonatal Arrhythmias.
Jaeggi E, Öhman A
Clin Perinatol 2016 Mar;43(1):99-112. doi: 10.1016/j.clp.2015.11.007. PMID: 26876124
Calcium handling and atrial fibrillation.
Heijman J, Voigt N, Nattel S, Dobrev D
Wien Med Wochenschr 2012 Jul;162(13-14):287-91. doi: 10.1007/s10354-012-0109-9. PMID: 22695810
Pediatric dysrhythmias.
Doniger SJ, Sharieff GQ
Pediatr Clin North Am 2006 Feb;53(1):85-105, vi. doi: 10.1016/j.pcl.2005.10.004. PMID: 16487786
Mitral valve regurgitation.
O'Rourke RA, Crawford MH
Curr Probl Cardiol 1984 May;9(2):1-52. doi: 10.1016/0146-2806(84)90021-5. PMID: 6375982

Prognosis

Arrhythmias in Williams Syndrome.
Deitch AM, Giacone HM, Chubb H, Algaze CA, Lechich KM, Collins RT
Am J Cardiol 2023 May 15;195:91-97. Epub 2023 Apr 8 doi: 10.1016/j.amjcard.2023.03.004. PMID: 37037070
Aberrant Ventricular Conduction: Revisiting an Old Concept.
Morton MB, Morton JB, Mond HG
Heart Lung Circ 2023 May;32(5):555-566. Epub 2023 Mar 24 doi: 10.1016/j.hlc.2023.03.001. PMID: 36967303
Deep learning for comprehensive ECG annotation.
Teplitzky BA, McRoberts M, Ghanbari H
Heart Rhythm 2020 May;17(5 Pt B):881-888. doi: 10.1016/j.hrthm.2020.02.015. PMID: 32354454Free PMC Article
Differentiating junctional tachycardia and atrioventricular node re-entry tachycardia based on response to atrial extrastimulus pacing.
Padanilam BJ, Manfredi JA, Steinberg LA, Olson JA, Fogel RI, Prystowsky EN
J Am Coll Cardiol 2008 Nov 18;52(21):1711-7. doi: 10.1016/j.jacc.2008.08.030. PMID: 19007691
Mitral valve regurgitation.
O'Rourke RA, Crawford MH
Curr Probl Cardiol 1984 May;9(2):1-52. doi: 10.1016/0146-2806(84)90021-5. PMID: 6375982

Clinical prediction guides

Arrhythmias in Williams Syndrome.
Deitch AM, Giacone HM, Chubb H, Algaze CA, Lechich KM, Collins RT
Am J Cardiol 2023 May 15;195:91-97. Epub 2023 Apr 8 doi: 10.1016/j.amjcard.2023.03.004. PMID: 37037070
High Burden of Premature Ventricular Complex Increases the Risk of New-Onset Atrial Fibrillation.
Lee PT, Huang MH, Huang TC, Hsu CH, Lin SH, Liu PY
J Am Heart Assoc 2023 Feb 21;12(4):e027674. Epub 2023 Feb 15 doi: 10.1161/JAHA.122.027674. PMID: 36789835Free PMC Article
Premature Atrial Contractions and Their Association with Stroke Features and Outcome.
Liu HY, Wu JY, Chung CP, Lee IH, Lin CJ, Lin CJ, Hsu LC, Chao TF
J Stroke Cerebrovasc Dis 2020 Oct;29(10):105118. Epub 2020 Jul 11 doi: 10.1016/j.jstrokecerebrovasdis.2020.105118. PMID: 32912526
Deep learning for comprehensive ECG annotation.
Teplitzky BA, McRoberts M, Ghanbari H
Heart Rhythm 2020 May;17(5 Pt B):881-888. doi: 10.1016/j.hrthm.2020.02.015. PMID: 32354454Free PMC Article
Dual atrioventricular nodal non-re-entrant tachycardia.
Peiker C, Pott C, Eckardt L, Kelm M, Shin DI, Willems S, Meyer C
Europace 2016 Mar;18(3):332-9. Epub 2015 Apr 16 doi: 10.1093/europace/euv056. PMID: 25888570

Recent systematic reviews

False-positive alarms in patients with implantable loop recorder followed by remote monitoring: A systematic review.
Covino S, Russo V
Pacing Clin Electrophysiol 2024 Mar;47(3):406-416. Epub 2024 Feb 11 doi: 10.1111/pace.14941. PMID: 38341627
Sudden cardiac death, arrhythmias and abnormal electrocardiography in systemic sclerosis: A systematic review and meta-analysis.
Fairley JL, Ross L, Quinlivan A, Hansen D, Paratz E, Stevens W, Kistler PM, McLellan A, La Gerche A, Nikpour M
Semin Arthritis Rheum 2023 Oct;62:152229. Epub 2023 Jun 19 doi: 10.1016/j.semarthrit.2023.152229. PMID: 37354723
Excessive Supraventricular Ectopic Activity and Adverse Cardiovascular Outcomes: a Systematic Review and Meta-analysis.
Meng L, Tsiaousis G, He J, Tse G, Antoniadis AP, Korantzopoulos P, Letsas KP, Baranchuk A, Qi W, Zhang Z, Liu E, Xu G, Xia Y, Li G, Roever L, Lip GY, Fragakis N, Liu T
Curr Atheroscler Rep 2020 May 21;22(4):14. doi: 10.1007/s11883-020-0832-4. PMID: 32440839
Frequent premature atrial contractions are associated with atrial fibrillation, brain ischaemia, and mortality: a systematic review and meta-analysis.
Himmelreich JCL, Lucassen WAM, Heugen M, Bossuyt PMM, Tan HL, Harskamp RE, van Etten-Jamaludin FS, van Weert HCPM
Europace 2019 May 1;21(5):698-707. doi: 10.1093/europace/euy276. PMID: 30508087
Premature atrial complexes in an ischemic stroke population and risk of recurrent stroke: a systematic review.
Sejr MH, Riahi S, Larsen TB, Nielsen JC, Nielsen PB
Expert Rev Cardiovasc Ther 2017 Jun;15(6):447-455. Epub 2017 Jun 5 doi: 10.1080/14779072.2017.1332992. PMID: 28532180

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