{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T17:13:39Z","timestamp":1791825219184,"version":"4.3.4"},"reference-count":41,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: There is a well-established correlation between premature ventricular contractions (PVCs) and atrial fibrillation (AF), with a higher burden of PVCs increasing the likelihood of new-onset AF. This study aims to investigate the impact of heart rate variability (HRV) on the onset of AF in patients with moderate to high burdens of PVCs, as observed through 24 h ambulatory electrocardiogram (ECG) analysis. Materials and Methods: Our study was a retrospective analysis involving 187 patients at a single tertiary center. We analyzed PVC counts from 24 h ECG recordings, categorizing the patients into groups based on whether they developed AF or not. Additionally, we developed a nomogram to estimate the risk of AF development in these patients. Results: A new-onset AF was detected in 16% of the cohort. Analysis of 24 h ambulatory ECG data revealed statistically significant increases in the SDNN index, RMSSD, PNN50, total power (TP), and low-frequency (LF) values in AF patients. To estimate the risk of AF, a risk prediction nomogram was created using high-frequency (HF), LF, SDNN index, and PNN50. Among these variables, PNN50 was identified as the strongest predictor in the multivariable model. Additionally, a decision curve analysis demonstrated that the nomogram offers a net clinical benefit for detecting AF in patients when the baseline threshold risk exceeds 15%. Conclusions: Our study found that among patients with AF who had a moderate to high burden of PVCs using 24 h ambulatory ECGs, several HRV parameters were elevated. This increased autonomic instability may play a role in the development and persistence of AF episodes.<\/jats:p>","DOI":"10.3390\/medicina62020243","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T17:52:38Z","timestamp":1769190758000},"page":"243","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Heart Rate Variability Nomogram Predicts Atrial Fibrillation in Patients with Moderate to High Burden of Premature Ventricular Complexes"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3596-3857","authenticated-orcid":false,"given":"Koray","family":"Kalenderoglu","sequence":"first","affiliation":[{"name":"Department of Cardiology, Health Sciences University, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Hospital, 34668 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6515-7349","authenticated-orcid":false,"given":"Mert Ilker","family":"Hayiroglu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Health Sciences University, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Hospital, 34668 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8188-5020","authenticated-orcid":false,"given":"Tufan","family":"Cinar","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Maryland Midtown Campus, Baltimore, MD 21201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3165-6769","authenticated-orcid":false,"given":"Faysal","family":"Saylik","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Van Education and Research Hospital, 65300 Van, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0934-7129","authenticated-orcid":false,"given":"Gokcem","family":"Ayan Bayraktar","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Umraniye Training and Research Hospital, 34760 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0574-5776","authenticated-orcid":false,"given":"Melih","family":"Oz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Umraniye Training and Research Hospital, 34760 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6944-8393","authenticated-orcid":false,"given":"Miray","family":"Ozer Oz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Health Sciences University, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Hospital, 34668 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2512-3176","authenticated-orcid":false,"given":"Kadir","family":"Gurkan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Health Sciences University, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Hospital, 34668 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8061-9660","authenticated-orcid":false,"given":"Tolga","family":"Aksu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Istanbul Aydin University, Medicalpark Florya Hospital, 34295 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.ijcard.2014.11.110","article-title":"Long-term outcome of multiform premature ventricular complexes in structurally normal heart","volume":"180","author":"Lin","year":"2015","journal-title":"Int. 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