Excessive Supraventricular Ectopic Activity and Adverse Cardiovascular Outcomes: a Systematic Review and Meta-analysis

Lei Meng, Georgios Tsiaousis, Jinli He, Gary Tse, Antonios P. Antoniadis, Panagiotis Korantzopoulos, Konstantinos P. Letsas, Adrian Baranchuk, Wenwei Qi, Zhiwei Zhang, Enzhao Liu, Gang Xu, Yunlong Xia, Guangping Li, Leonardo Roever, Gregory Yh Lip, Nikolaos Fragakis, Tong Liu

Research output: Contribution to journalReview articlepeer-review

10 Citations (Scopus)


Purpose of Review: Excessive supraventricular ectopic activity (ESVEA), in the form of frequent premature atrial contractions (PACs) and runs of PACs, is commonly observed in clinical practice and is frequently considered to be benign. Yet, recent studies have demonstrated a link between ESVEA and adverse cardiovascular outcomes. The aim of this meta-analysis was to examine the association between ESVEA and the risk of atrial fibrillation (AF), stroke, and mortality. Recent Findings: A systematic search was performed in PubMed, EMBASE, and the Cochrane Library up to December 2017 to identify studies assessing adverse cardiovascular outcomes in patients with ESVEA, recorded on ambulatory electrocardiography. ESVEA was defined as a burden of PACs > 30 PACs/h or any runs of ≥20 PACs. The risk estimates for EVSEA and each clinical endpoint were pooled and analyzed separately. Results: Five studies comprising 7545 participants were included in this meta-analysis. The pooled analysis showed that ESVEA doubled the risk of AF (HR 2.19, 95% CI 1.70–2.82). ESVEA was also associated with a higher incidence of stroke (HR 2.23, 95% CI 1.24–4.02). Finally, ESVEA was associated with higher all-cause mortality (HR 1.61, 95% CI 1.25–2.07). Summary: Our meta-analysis found that ESVEA is closely associated with AF, stroke, and all-cause mortality. Further studies are required to examine the implication of therapeutic strategies in patients with ESVEA, in order to prevent potential subsequent adverse cardiovascular outcomes.

Original languageEnglish
Article number14
JournalCurrent Atherosclerosis Reports
Issue number4
Publication statusPublished - 1 Apr 2020
Externally publishedYes


  • Atrial fibrillation
  • Excessive supraventricular ectopy
  • Mortality
  • Stroke


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