Prediction of Paroxysmal Atrial Fibrillation in Patients with Sinus Rhythm

Olga A. Germanova 1 * , Yulia Reshetnikova 2, Andrey Germanov 3, Giuseppe Galati 4, Inga Prokhorenko 3
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1 Department of clinical medicine of postgraduate education, Medical University Reaviz, Samara, Russia
2 Laboratory of cardiovisualization, Samara State Medical University, Samara, Russia
3 Department of internal diseases, Medical University Reaviz, Samara, Russia
4 Cardiovascular department, I.R.C.C.S. Ospedale Multimedica – Cardiovascular Scientific Institute, Milan, Italy
* Corresponding Author
J CLIN MED KAZ, Volume 23, Issue 3, pp. 24-30. https://doi.org/10.23950/jcmk/18532
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Author Contributions: Conceptualization, A. G.; methodology, O. G. and A. G.; validation, O. G. and Y. R.; formal analysis, G. G.; investigation, O. G. and Y. R.; resources, Y. R.; data curation, A. G.; writing – original draft preparation, O. G.; writing – review and editing, A. G. and G. G.; visualization, Y. R.; supervision, I. P.; project administration, O. G. and I. P.; funding acquisition, Y. R. All authors have read and agreed to the published version of the manuscript.

Data availability statement: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Artificial Intelligence (AI) Disclosure Statement: The authors declare no AI Tools used for preparation of this work.

ABSTRACT

Objective: To create a tool for the prediction of paroxysmal atrial fibrillation (PAF) in patients with sinus rhythm.
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 of ST segment, QT interval durations, and heart rate variability.
Results: We formulated a regression equation to estimate the probability of PAF in patients with sinus rhythm. The most significant risk predictors: early "P on T" premature ectopic complexes (p<0.0001); coupled premature ventricular ectopic complexes (p=0.021); ventricular allorhythmias (OR=0.997). Other analyzed factors, including the frequency of both atrial and atrioventricular premature ectopic complexes, as well as single ventricular ectopic complexes, did not exhibit a statistically significant effect on the risk of PAF, according to this model.
Conclusion: The final regression equation, based on the evaluation of data from 24-hours Holter ECG monitoring, incorporates the following criteria: gender, the number of atrial and atrioventricular supraventricular complexes, the count of single and paired ventricular complexes, variations in rhythms with ventricular complexes, as well as the presence or absence of early "P on T" complexes (AUC=0.996).
Keywords: atrial fibrillation, premature complexes, paroxysmal atrial fibrillation, predictive equation.

CITATION

Germanova OA, Reshetnikova Y, Germanov A, Galati G, Prokhorenko I. Prediction of Paroxysmal Atrial Fibrillation in Patients with Sinus Rhythm. J CLIN MED KAZ. 2026;23(3):24-30. https://doi.org/10.23950/jcmk/18532

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