Abstract P022: The Association of Sleep Apnea With Atrial Fibrillation and Ectopy Using Ambulatory Electrocardiogram in the Atherosclerosis Risk in Communities (ARIC) Study

Introduction: Sleep apnea (SA) is associated with burden of atrial fibrillation (AF), but studies of SA and ectopic beats, potential triggers of AF, are sparse. Our study contributes by examining the association of SA with AF, premature atrial contractions (PACs), and premature ventricular contractions (PVCs) from 48-hour continuous ambulatory electrocardiogram (aECG) monitoring. Methods: The study population includes 716 black and 438 white participants from the ARIC 48-hour aECG ancillary study, after excluding those with a paced rhythm (n=43) or poor quality measures (n=8). SA was defined as self-reported physician diagnosis or hospital discharge records with ICD-9-CM codes for SA. Prevalent AF was defined using 48-hour aECG monitoring, study visit ECGs, or hospital discharge code (427.3) since study baseline in 1986-1987. PACs and PVCs were defined if ectopy was present 1-5% (occasional) and >5% (frequent) of the recording time versus <1% of the recording time (referent). Multivariable logistic regression was used to examine this association with inverse variance weighting to account for the sampling and non-response. Results: Participants with SA (unweighted N=217) were more likely to be female (55%), white race (52%), current smokers (57%), have hypertension (82%), and be obese (57%). Participants with SA were 7.3 (95% CI: 3.7, 14.5) times more likely to have AF compared to those without SA after adjusting for covariates. Compared to participants without SA, the relative odds of occasional and frequent PACs versus the referent was increased by 20% and 50% respectively among participants with SA after adjusting for confounders, although not statistically significant. The association was similar and not statistically significant for frequent PVCs. Conclusions: In a community-based population using standardized 48-hour aECG monitoring, SA was associated with prevalent AF, but not significantly associated with PACs or PVCs. Further study is needed to establish mechanisms that link SA and cardiac arrhythmias.

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The Association of Sleep Apnea, Diagnosed by Self-reported Physician Diagnosis or Hospital Discharge Codes, with Atrial Fibrillation and Ectopy using Ambulatory Electrocardiogram in the Atherosclerosis Risk in Communities (ARIC) Study

Circulation Arrhythmia and Electrophysiology ◽

10.1161/circep.119.007574 ◽

2020 ◽

Cited By ~ 1

Author(s):

Kapuaola S. Gellert ◽

Alvaro Alonso ◽

Lin Y. Chen ◽

Michelle L. Meyer ◽

Elsayed Z. Soliman ◽

...

Keyword(s):

Atrial Fibrillation ◽

Sleep Apnea ◽

Hospital Discharge ◽

Atherosclerosis Risk In Communities ◽

Atherosclerosis Risk ◽

Aric Study ◽

Physician Diagnosis

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Association of Ventricular Arrhythmias with Dementia: The Atherosclerosis Risk in Communities (ARIC) Study

Neurology ◽

10.1212/wnl.0000000000011122 ◽

2020 ◽

pp. 10.1212/WNL.0000000000011122

Author(s):

Faye L Norby ◽

Alvaro Alonso ◽

Mary R Rooney ◽

Ankit Maheshwari ◽

Ryan J Koene ◽

...

Keyword(s):

Population Based ◽

Recording Device ◽

Cross Sectional ◽

Premature Ventricular Contractions ◽

Recording Time ◽

Atherosclerosis Risk In Communities ◽

Wide Complex Tachycardia ◽

Underlying Mechanisms ◽

Sectional Analysis ◽

Aric Study

Objective–We performed a cross-sectional analysis to determine whether nonsustained ventricular tachycardia (NSVT) and premature ventricular contractions (PVCs) were associated with dementia in a population-based study.Methods– We included 2517 (mean age 79; 26% black) participants who wore a 2-week ambulatory continuous ECG recording device in 2016-17. NSVT was defined as a wide complex tachycardia ≥ 4 beats with a rate >100 beats per minute. We calculated NSVT and PVC burden as the number of episodes per day. Dementia was adjudicated by experts. We used logistic regression to assess the associations of NSVT and PVCs with dementia.Results– The mean recording time of the Zio® XT Patch was 12.6 ± 2.6 days. There were 768 (31%) participants with NSVT; prevalence was similar in whites and blacks. There were 134 (6.5%) dementia cases (5% in whites; 10% in blacks). After multivariable adjustment, there was no overall association between NSVT and dementia; however, there was a significant race interaction (p<0.001). In blacks, NSVT was associated with a 3.67 times higher adjusted odds of dementia (95% CI = 1.92-7.02) compared to those without NSVT, whereas in whites NSVT was not associated with dementia [OR (95% CI) = 0.64 (0.37-1.10)]. In blacks only, a higher burden of PVCs was associated with dementia.Conclusions– Presence of NSVT and a higher burden of NSVT and PVCs are associated with dementia in elderly blacks. Further research to confirm this novel finding and elucidate the underlying mechanisms is warranted.

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Abstract 12385: Past Alcohol Consumption and Incident Atrial Fibrillation

Circulation ◽

10.1161/circ.132.suppl_3.12385 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Shalini Dixit ◽

Alvaro Alonso ◽

Elsayed Z Soliman ◽

Lin Y Chen ◽

Gregory M Marcus

Keyword(s):

Atrial Fibrillation ◽

Alcohol Consumption ◽

Alcohol Use ◽

Population Based ◽

Self Report ◽

Atherosclerosis Risk In Communities ◽

Increased Risk ◽

Before And After ◽

Dietary Intake Assessment ◽

Aric Study

Introduction: Although current alcohol consumption appears to be a risk factor for incident atrial fibrillation (AF), limitations related to self-reported alcohol use and confounding in observational studies limit the certainty of conclusions regarding causality. Whether cessation of alcohol consumption can protect against incident AF remains unknown. Methods: We examined all participants in the Atherosclerosis Risk in Communities (ARIC) study, a population-based cohort of 15,792 men and women aged 45-65, without prevalent AF. Past alcohol consumption was assessed via self-report during the baseline dietary intake assessment. Cases of incident AF were ascertained via study ECGs, hospital discharge ICD-9 codes, and death certificates. Results: Among 15,262 participants with complete survey data, 2,898 (19.0%) were former drinkers. During an average follow-up of 17.4 years, there were 380 cases of incident AF in former consumers. Both before and after adjustment for potential confounders, a longer duration of alcohol abstinence was associated with a lower risk of developing AF; previously consuming alcohol for a longer duration and consuming a greater quantity of alcohol were each associated with a higher risk of developing AF (Table). Conclusions: Among former drinkers, the number of years of drinking and the amount of alcohol consumed may each confer an increased risk of AF. Given that a longer duration of abstinence was associated with a decreased risk of AF, modification of alcohol use could potentially play a role in AF prevention.

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Abstract 15380: Association of Change in Body Mass Index With Premature Atrial Contractions Frequency and Atrial Fibrillation in Older Age: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽

10.1161/circ.142.suppl_3.15380 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Joseph Decker ◽

Wendy Wang ◽

Faye L Norby ◽

Romil Parikh ◽

Jorge L Reyes ◽

...

Keyword(s):

Atrial Fibrillation ◽

Body Mass Index ◽

Body Mass ◽

The Elderly ◽

Atherosclerosis Risk In Communities ◽

Aging Adults ◽

Aric Study ◽

Multivariable Adjustment ◽

Adjustment Table

Introduction: The proportions of obese and aging adults are rapidly growing. While obesity and advancing age are associated with atrial fibrillation (AF), data are limited on weight change in the elderly as a risk factor for premature atrial contractions (PACs)—which are known to precede AF—or AF. Hypothesis: Compared to a stable body mass index (BMI) over time, increasing BMI will be associated with a higher PAC frequency and AF in elderly participants in ARIC. Methods: We included N=2,070 ARIC participants [age mean ± SD 79 ± 4.5 years, 59% female] without known AF who attended visit 6 and wore an ambulatory ECG-monitoring device (Zio XT® Patch, iRhythm Technologies Inc.) for ≥48 hours. BMI change was defined as change between V5 (2011-13) and V6 (2016-17) and was categorized into 4 groups: >10% decrease, 2 to 10% decrease, -2 to 2% change (stable BMI) and > 2% increase. PAC frequency was defined as percent of beats that are PACs. Linear regression was used to evaluate the association between BMI change and % PAC. Incident AF was ascertained after V6 through 2018 from hospital discharge codes and death certificates. Logistic regression was used to evaluate the association between BMI change and incident AF. Results: Median PACs per hour were 8.84. Participants with >2% BMI increase had 0.35% (95% CI: 0.06%-0.64%) higher frequency of PACs compared to those with stable BMI after multivariable adjustment (Table). After a mean (SD) follow-up of 19 (7) months, there were 82 incident AF cases. Compared to stable BMI, both >2% BMI increase and 2 to 10% decrease were nonsignificantly associated with higher odds of AF compared with stable BMI after multivariable adjustment (Table). Conclusion: Increasing BMI in the elderly is associated with higher PAC frequency and is nonsignificantly associated with higher odds of AF compared to stable BMI. This finding suggests that weight management, which is currently emphasized in middle age, may also apply in late-life to prevent atrial arrhythmias.

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