Prediction of paroxysmal atrial fibrillation in patients with sinus rhythm

Objective. To create a tool for the prediction of paroxysmal atrial fibrillation (PAF) in patients with sinus rhythm.
Materials and methods. Single-center case-control study. None of the patients had a prior diagnosis of AF or reported symptoms of heart arrhythmias. Among the cohort of 6,630 individuals, paroxysms of AF were incidentally detected during 24-hours Holter ECG monitoring in 97 patients (main group). The control group - 99 patients from the same primary cohort without PAF. We assessed supraventricular and ventricular ectopic activity, the presence of pauses and blocks, changes in the ST segment, QT interval durations, and heart rate variability.
Results. The most significant risk predictors for developing PAF: 1. The presence of early "P on T" ectopic complexes (p<0.0001). When "P on T" ectopic complexes were present, the likelihood of developing PAF increased 8461 times. 2. Paired ventricular ectopic complexes, where an increase in their number correlated with a reduced probability of PAF (p=0.021). 3. Ventricular allorhythmias. Higher incidence of these episodes during ventricular ectopic activity was linked to a diminished risk of PAF (OR=0.997).
Conclusions. “Arfa” equation:
Pr (Arfa) = 1 / (1 + EXP ( - ( - 3,65982 + 0,000144 * Atrial ES + 0,000354 * Atrioventricular ES + 0,000842 * Single ventricular ES - 0,01613 * Couple ventricular ES - 0,002863 * Ventricular allorhythmias - 1,596521 * Gender m + 9,043299 * «Р on Т» ES))).
Pr (Arfa) > 0.5 - high risk of PAF. Pr (Arfa) < 0.5 -  low risk of PAF (AUC=0,996).