Analysis of the Electrocardiograms Obtained from 1000 Young Healthy Aviators

Packard, John M.; Graettinger, John S.; Graybiel, Ashton

doi:10.1161/01.cir.10.3.384

Cited by 124 publications

(61 citation statements)

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“…In the first study on the natural course of prolonged PR interval involving 1000 young aviators from the US Army, no cardiac mortality or evidence of heart disease was demonstrated in the individuals with PR interval .200 ms during the 10-year follow-up, although 20% of the subjects died, mainly due to accidents and aerial combat. 3 Subsequent studies conducted on over 18 000 male civil servants with a 5-year follow-up, 6 and almost 4000 pilots recruited after World War II with a 30-year follow-up 5 could not show any association between prolonged PR interval ≥220 ms and mortality or CAD, although some studies have provided somewhat contradictory evidence on the relation between PR interval and incidence of CAD. 19,20 Only two major community-based studies have looked into the prognostic significance of the first-degree AV block in the general population.…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of prolonged PR interval in the general population

Aro

Anttonen

Kerola

et al. 2013

European Heart Journal

120

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AimsProlonged PR interval, or first degree AV block, has been traditionally regarded as a benign electrocardiographic finding in healthy individuals, until recent studies have suggested that it may be associated with increased mortality and morbidity. The aim of this study was to further elucidate clinical and prognostic importance of prolonged PR interval in a large middleaged population with a long follow-up. Methods and resultsWe evaluated 12-lead electrocardiograms of 10 785 individuals aged 30 -59 years (mean age 44 years, 52% males) recorded between 1966 and 1972, and followed the subjects for 30 + 11 years. Prolonged PR interval was defined as PR .200 ms, with further analysis performed using PR ≥220 ms. Main endpoints were all-cause mortality, cardiovascular mortality, and sudden cardiac death, and other endpoints included hospitalizations due to cardiovascular causes. During the baseline examination, prolonged PR interval .200 ms was present in 2.1% of the subjects, but PR interval normalized to ≤200 ms in 30% of these individuals during the follow-up. No increase in mortality or in hospitalizations due to coronary artery disease, heart failure, atrial fibrillation, or stroke was associated with prolonged PR interval (P ¼ non-significant for all endpoints). These results were not changed after multivariate adjustment or in several subanalyses. ConclusionIn the middle-aged general population, prolonged PR interval normalizes in a substantial proportion of subjects during the time course, and it is not associated with an increased risk of all-cause or cardiovascular mortality.--

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Section: Discussionmentioning

confidence: 99%

Prognostic significance of prolonged PR interval in the general population

Aro

Anttonen

Kerola

et al. 2013

European Heart Journal

120

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“…One to 3 in 1000 individuals has accessory myocardial pathways that cross the annulus fibrosus and bypass the atrioventricular conduction axis. These accessory pathways are known as bundles of Kent and Mahaim (Packard et al, 1954;Munger et al, 1993). Bundles of Kent are associated with fast conduction and express Cx43 (Peters et al, 1994).…”

Section: Atrioventricular Canal Development and The Formation Of Accementioning

confidence: 99%

Origin and development of the atrioventricular myocardial lineage: Insight into the development of accessory pathways

Aanhaanen

Moorman

Christoffels

2011

Birth Defects Research

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Defects originating from the atrioventricular canal region are part of a wide spectrum of congenital cardiovascular malformations that frequently affect newborns. These defects include partial or complete atrioventricular septal defects, atrioventricular valve defects, and arrhythmias, such as atrioventricular re-entry tachycardia, atrioventricular nodal block, and ventricular preexcitation. Insight into the cellular origin of the atrioventricular canal myocardium and the molecular mechanisms that control its development will aid in the understanding of the etiology of the atrioventricular defects. This review discusses current knowledge concerning the origin and fate of the atrioventricular canal myocardium, the molecular mechanisms that determine its specification and differentiation, and its role in the development of certain malformations such as those that underlie ventricular preexcitation.

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“…Normally, the only muscular connection that crosses this insulation is formed by the atrioventricular (AV) node and AV bundle. In the general population, 1-3 in 1,000 individuals have accessory myocardial pathways that bypass the insulation, known as bundles of Kent (1,2). These accessory connections may lead to preexcitation of the ventricle, circus movement tachycardia, and even life-threatening ventricular fibrillation in the presence of atrial fibrillation, as seen in Wolff-Parkinson-White syndrome patients (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%