AUTHOR=Guichard Jean-Baptiste , Guasch Eduard , Roche Frederic , Da Costa Antoine , Mont Lluís 

TITLE=Premature atrial contractions: A predictor of atrial fibrillation and a relevant marker of atrial cardiomyopathy

JOURNAL=Frontiers in Physiology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2022.971691

DOI=10.3389/fphys.2022.971691

ISSN=1664-042X

ABSTRACT=The increased burden of premature atrial contractions has long been considered a benign
phenomenon. However, strong evidence of its involvement in the occurrence of atrial
fibrillation(AF), ischemic stroke, and excess mortality suggests the need for its management.
The central question to be resolved is whether increased atrial excitability is only a predictor
of AF or whether it is a marker of atrial cardiomyopathy and therefore of ischemic stroke.
After reviewing the pathophysiology of atrial excitability and its impact on patient prognosis,
this mini-review proposes to (i) detail the physiological and clinical elements linking atrial
excitability and AF, (ii) present the evidence in favor of atrial excitability as a marker of
cardiomyopathy, and (iii) outline the current limitations of this concept and the potential
future clinical implications.