Predisposing factors of short paroxysmal atrial runs in the geriatric patients

Paroxysmal atrial runs in the geriatric patients




Atrial ectopic tachycardia, atrial flutter, geriatrics


Objective: Atrial fibrillation (AF) is the most common arrhythmia in the elderly population, and it has various major complications. This study aimed to investigate the factors that may cause short paroxysmal atrial runs (SPARs) in the geriatric patients.

Methods: The study included patients aged over 65 years who visited the cardiology outpatient clinic and were diagnosed with SPAR by a 24-hour electrocardiogram holter (24-h ECG). All patients underwent echocardiography, and their plasma C-reactive protein (CRP) levels were measured. Their demographic data, chronic disease status, echocardiographic findings and CRP values were evaluated.

Results: The mean age of the 144 patients was 73 (65-90). Of the patients, 70.8% were female and 29.2% were male. There was no significant difference between the groups with and without SPAR in terms of age (p=0.362), sex (p=0.549), hypertension (p=0.345), congestive heart failure (0.668), diabetes mellitus (p=0.150), coronary artery disease (p=0.518), ejection fraction (p=0.577), or left atrial area (p=0.696). In the univariate regression analysis, diabetes mellitus and plasma CRP levels were associated with the risk of SPAR. In the multivariate logistic regression analysis model including diabetes mellitus (OR:1.996; 95% CI: (0.616–6.472); p=0.249) and plasma CRP levels (OR: 0.325; 95% CI: (0.049–2.143); p=0.243), neither factor was found to be independently associated with the risk of SPAR.

Conclusion: Clinical conditions that are known to increase the risk of developing atrial fibrillation, such as hypertension and congestive heart failure, were not associated with the development of SPAR.


Lip GYH, Proietti M, Potpara T, Mansour M, Savelieva I, Tse HF, et al. Atrial fibrillation and stroke prevention: 25 years of research at EP Europace journal. Europace. 2023;25:euad226.

Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke. 1991;22:983-8.

Frustaci A, Chimenti C, Bellocci F, Morgante E, Russo MA, Maseri A. Histological substrate of atrial biopsies in patients with lone atrial fibrillation. Circulation. 1997;96:1180-4.

Ömür SE, Zorlu Ç, Yılmaz M. Comparison of the Relationship Between Inflammatory Markers and Atrial Fibrillation Burden. Anatol J Cardiol. 2023;27:486-93.

Fredriksson T, Gudmundsdottir KK, Frykman V, Friberg L, Al-Khalili F, Engdahl J, et al. Brief episodes of rapid irregular atrial activity (micro-AF) are a risk marker for atrial fibrillation: a prospective cohort study. BMC Cardiovasc Disord. 2020;20:167.

Himmelreich JCL, Lucassen WAM, Heugen M, Bossuyt PMM, Tan HL, Harskamp RE, et al. Frequent premature atrial contractions are associated with atrial fibrillation, brain ischemia, and mortality: a systematic review and meta-analysis. Europace. 2019;21:698-707.

Benjamin EJ, Levy D, Vaziri SM, D'Agostino RB, Belanger AJ, Wolf PA. Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham Heart Study. JAMA. 1994;271:840-4.

Preda A, Carbone F, Tirandi A, Montecucco F, Liberale L. Obesity phenotypes and cardiovascular risk: From pathophysiology to clinical management. Rev Endocr Metab Disord. 2023;24:901-19.

Grond M, Jauss M, Hamann G, Stark E, Veltkamp R, Nabavi D, et al. Improved detection of silent atrial fibrillation using 72-hour Holter ECG in patients with ischemic stroke: a prospective multicenter cohort study. Stroke. 2013;44:3357–64.

Haeusler KG, Kirchhof P, Kunze C, Tutuncu S, Fiessler C, Malsch C, et al. Systematic monitoring for detection of atrial fibrillation in patients with acute ischaemic stroke (MonDAFIS): a randomised, open-label, multicentre study. Lancet Neurol. 2021;20:426–36.

Noubiap JJ, Thomas G, Middeldorp ME, Fitzgerald JL, Harper C, Sanders P. Atrial fibrillation detection using insertable cardiac monitor after stroke: a real-world cohort study. J Cardiovasc Electrophysiol. 2023;34:142–6.

Gladstone DJ, Wachter R, Schmalstieg-Bahr K, Quinn FR, Hummers E, Ivers N, et al. Screening for atrial fibrillation in the older population: a randomized clinical trial. JAMA Cardiol. 2021;6:558–67.

Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomstrom-Lundqvist C, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): the Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J. 2021;42:373–498.

Toennis T, Bertaglia E, Brandes A, Dichtl W, Fluschnik N, de Groot JR, et al. The influence of atrial high-rate episodes on stroke and cardiovascular death: an update. Europace. 2023;25:7:euad166.

Miyazawa K, Pastori D, Martin DT, Choucair WK, Halperin JL, Lip GYH, et al. Characteristics of patients with atrial high rate episodes detected by implanted defibrillator and resynchronization devices. Europace. 2022;24:375–83.

Takahashi Y, Yamaguchi T, Otsubo T, Nakashima K, Shinzato K, Osako R, et al. Histological validation of atrial structural remodeling in patients with atrial fibrillation. Eur Heart J. 2023;44:3339-53.

Lubitz SA, Faranesh AZ, Selvaggi C, Atlas SJ, McManus DD, Singer DE, et al. Detection of atrial fibrillation in a large population using wearable devices: the Fitbit heart study. Circulation. 2022;146:1415–24.

Rizas KD, Freyer L, Sappler N, von Stulpnagel L, Spielbichler P, Krasniqi A, et al. Smartphone-based screening for atrial fibrillation: a pragmatic randomized clinical trial. Nat Med. 2022;28:1823–30.

Fabritz LC, Czarnecki E, Dudek E, Guasch E, Haase D, Huebner T, et al. Smartphone and wearable detected atrial arrhythmias in Older Adults: results of a fully digital European Case finding study. Eur Heart J Digital Health. 2022;3:610–25.

Dzeshka MS, Lip GY, Snezhitskiy V, Shantsila E. Cardiac Fibrosis in Patients With Atrial Fibrillation: Mechanisms and Clinical Implications. J Am Coll Cardiol. 2015;66:943-59.

Farinha JM, Gupta D, Lip GYH. Frequent premature atrial contractions as a signaling marker of atrial cardiomyopathy, incident atrial fibrillation, and stroke. Cardiovasc Res. 2023;119:429-39.

Binici Z, Intzilakis T, Nielsen OW, Køber L, Sajadieh A. Excessive supraventricular ectopic activity and increased risk of atrial fibrillation and stroke. Circulation. 2010;121:1904-11.

Johnson LS, Juhlin T, Juul-Möller S, Hedblad B, Nilsson PM, Engström G. A prospective study of supraventricular activity and incidence of atrial fibrillation. Heart Rhythm. 2015;12:1898-904.

Engström G, Hedblad B, Juul-Möller S, Tydén P, Janzon L. Cardiac arrhythmias and stroke: increased risk in men with high frequency of atrial ectopic beats. Stroke. 2000;31:2925-9.

Johnson LSB, Persson AP, Wollmer P, Juul-Möller S, Juhlin T, Engström G. Irregularity and lack of p waves in short tachycardia episodes predict atrial fibrillation and ischemic stroke. Heart Rhythm. 2018;15:805-11.

Liu T, Li G, Li L, Korantzopoulos P. Association between C-reactive protein and recurrence of atrial fibrillation after successful electrical cardioversion: a meta-analysis. J Am Coll Cardiol. 2007;49:1642-8.

Lin YJ, Tsao HM, Chang SL, Lo LW, Tuan TC, Hu YF, et al. Prognostic implications of the high-sensitive C-reactive protein in the catheter ablation of atrial fibrillation. Am J Cardiol. 2010;105:495-501.

Lellouche N, Sacher F, Wright M, Nault I, Brottier J, Knecht S, et al. Usefulness of C-reactive protein in predicting early and late recurrences after atrial fibrillation ablation. Europace. 2009;11:662-4.




How to Cite

Çakır, M. O. (2023). Predisposing factors of short paroxysmal atrial runs in the geriatric patients : Paroxysmal atrial runs in the geriatric patients. The Injector, 2(3), 216–221.



Original Article