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Atrial Ectopic Beats: Another Risk Factor for Stroke

To determine whether atrial ectopic beats (AEB) are a risk factor for stroke, these authors followed a population-based cohort of 402 men born in 1914 (age at baseline, 68) until death or December 31, 1996 -- a mean of 11 years. After prospectively analyzing cardiac rhythms in 24-hour ambulatory ECG recordings and documenting other potential risk factors for stroke in the men, the investigators identified all ischemic strokes, subarachnoid hemorrhages, intracerebral hemorrhages, and unclassifiable strokes.

The study confirmed that hypertension and atrial fibrillation are associated with increased risk for stroke and also suggested that a high frequency of AEB is an independent risk factor. AEB increased relative risk for stroke to 1.9 among all subjects and to 2.5 among hypertensive subjects. However, the actual incidence of stroke was significantly increased in hypertensive subjects only. Normotensive subjects were not studied independently.

Comment: AEB have been considered benign and unrelated to a risk for stroke or death, but this study suggests that more caution is needed. Independent analyses of normotensive and hypertensive subjects would have strengthened the study: The "risk" posed by AEB would have been more convincingly demonstrated if the incidence of stroke had been significantly increased in normotensive as well as in hypertensive subjects. Nevertheless, this first attempt to seek an association between stroke and AEB should be heeded, and further analyses should be undertaken to determine whether this putative risk factor requires expectant therapy. Indeed, study is needed to determine whether AEB are truly a risk factor for stroke or simply a marker of cardiac disease, which is itself a risk factor.

— WT Talman

William T. Talman, MD, is Professor of Neurology and Neuroscience, University of Iowa, and Chief of Neurology, Veterans Administration Medical Center, Iowa City, IA.

Published in Journal Watch Neurology February 21, 2001

Citation(s):

Engstrom G et al. Cardiac arrhythmias and stroke: Increased risk in men with high frequency of atrial ectopic beats. Stroke 2000 Dec 31 2925-2929.

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  • Different types of Ectopic Beats
    Thomas John, 7 Feb 2011 10:34 AM EST
    Specialty: Public Health/Gpm
    Atrial Ectopic Beats arising in the atria(the upper chambers of the heart):Atrial Ectopic beats are detected in an ECG(Electrocardiogram). They... [more]

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