P-wave duration and the risk of atrial fibrillation: Results from the Copenhagen ECG Study

Nielsen, Jonas B.; Kühl, Jørgen Tobias; Pietersen, Adrian; Graff, Claus; Lind, Bent; Struijk, Johannes; Olesen, Morten S.; Sinner, Moritz F.; Bachmann, Troels Nørgaard; Haunsø, Stig; Nordestgaard, Børge G.; Ellinor, Patrick T.; Svendsen, Jesper Hastrup; Kofoed, Klaus F.; Køber, Lars; Holst, Anders G.

doi:10.1016/j.hrthm.2015.04.026

Cited by 170 publications

(156 citation statements)

References 25 publications

Supporting

Mentioning

134

Contrasting

Unclassified

Order By: Relevance

“…We divided the population into 5 categories based on IAB; normal P‐wave duration (<120 ms), partial IAB (P‐wave duration ≥120 ms and no biphasic [plus/minus] P waves in inferior leads) and 3 groups of IAB (P‐wave duration ≥120 ms) associated with biphasic (plus/minus) P‐waves in 1, 2, or 3 inferior leads (II, III, and aVF), the latter representing the strictly defined advanced IAB . P‐wave duration was obtained as previously described, corresponding to the interval between the earliest detection of atrial depolarization in any lead and the latest detection of atrial depolarization in any lead. Amplitudes of significant waves within the P‐wave are measured with respect to a baseline level that is interpolated from P onset to P offset.…”

Section: Methodsmentioning

confidence: 99%

Risk Prediction of Atrial Fibrillation Based on Electrocardiographic Interatrial Block

Skov

Ghouse

Kühl

et al. 2018

JAHA

Self Cite

View full text Add to dashboard Cite

BackgroundThe electrocardiographic interatrial block (IAB) has been associated with atrial fibrillation (AF). We aimed to test whether IAB can improve risk prediction of AF for the individual person.Methods and ResultsDigital ECGs of 152 759 primary care patients aged 50 to 90 years were collected from 2001 to 2011. We identified individuals with P‐wave ≥120 ms and the presence of none, 1, 2, or 3 biphasic P‐waves in inferior leads. Data on comorbidity, medication, and outcomes were obtained from nationwide registries. We observed a dose‐response relationship between the number of biphasic P‐waves in inferior leads and the hazard of AF during follow‐up. Discrimination of the 10‐year outcome of AF, measured by time‐dependent area under the curve, was increased by 1.09% (95% confidence interval 0.43–1.74%) for individuals with cardiovascular disease at baseline (CVD) and 1.01% (95% confidence interval 0.40–1.62%) for individuals without CVD, when IAB was added to a conventional risk model for AF. The highest effect of IAB on the absolute risk of AF was observed in individuals aged 60 to 70 years with CVD. In this subgroup, the 10‐year risk of AF was 50% in those with advanced IAB compared with 10% in those with a normal P‐wave. In general, individuals with advanced IAB and no CVD had a higher risk of AF than patients with CVD and no IAB.Conclusions IAB improves risk prediction of AF when added to a conventional risk model. Clinicians may consider monitoring patients with IAB more closely for the occurrence of AF, especially for high‐risk subgroups.

show abstract

Section: Methodsmentioning

confidence: 99%

Risk Prediction of Atrial Fibrillation Based on Electrocardiographic Interatrial Block

Skov

Ghouse

Kühl

et al. 2018

JAHA

Self Cite

View full text Add to dashboard Cite

show abstract

“…The clinical utility of PWI have been demonstrated by their relation to atrial electrophysiology using invasive intracardiac studies, 2, 3 and by their assessment as risk factors for atrial fibrillation (AF). 4–7 P-wave terminal force – derived from the product of the duration of the negative phase of the P wave in lead V1 and its terminal depth (Figure 1) – has been used as an ECG marker for the presence of left atrial enlargement. 8 In addition to terminal force, P-wave duration has been used widely because of its accessibility from the electrocardiogram.…”

Section: Introductionmentioning

confidence: 99%

Fifteen Genetic Loci Associated With the Electrocardiographic P Wave

Christophersen¹,

Magnani²,

Yin³

et al. 2017

Circ Cardiovasc Genet

Self Cite

View full text Add to dashboard Cite

Background The P-wave on an electrocardiogram is a measure of atrial electrical function and its characteristics may serve as predictors for atrial arrhythmias. Increased mean P-wave duration and P-wave terminal force traditionally have been used as markers for left atrial enlargement and both have been associated with increased risk of atrial fibrillation. Here, we explore the genetic basis of P-wave morphology through meta-analysis of genome-wide association study (GWAS) results for P-wave duration and P-wave terminal force from twelve cohort studies. Methods and Results We included 44,456 individuals, of which 6,778 (16%) were of African ancestry. Genotyping, imputation, and GWAS were performed at each study site. Summary level results were meta-analyzed centrally using inverse-variance weighting. In meta-analyses of P-wave duration, we identified six significant (P<5×10−8) novel loci, and replicated a prior association with SCN10A. We identified three loci at SCN5A, TBX5, and CAV1/CAV2 that were jointly associated with the PR-interval, PR-segment, and P-wave duration. We identified six novel loci in meta-analysis of P-wave terminal force. Four of the identified genetic loci were significantly associated with gene expression in 329 left atrial samples. Finally, we observed that some of the loci associated with the P-wave were linked to overall atrial conduction, whereas others identified distinct phases of atrial conduction. Conclusions We have identified six novel genetic loci associated with P-wave duration and six novel loci associated with P-wave terminal force. Future studies of these loci may aid in identifying new targets for drugs that may modify atrial conduction or treat atrial arrhythmias.

show abstract

“…Morphological changes including increase in atrial size and P wave prolongation on 12-lead ECGs have been shown to be associated with new-onset AF following CABG 11. Similar associations of P wave duration and atrial size have been made with new-onset, non-postoperative AF 12. These morphological changes reflect an underlying tissue change of which atrial fibrosis is a major component.…”

mentioning

confidence: 75%

Persistently high incidence of postcoronary bypass atrial fibrillation: possible mechanisms

Akoum

2018

Heart

View full text Add to dashboard Cite

P-wave duration and the risk of atrial fibrillation: Results from the Copenhagen ECG Study

Cited by 170 publications

References 25 publications

Risk Prediction of Atrial Fibrillation Based on Electrocardiographic Interatrial Block

Risk Prediction of Atrial Fibrillation Based on Electrocardiographic Interatrial Block

Fifteen Genetic Loci Associated With the Electrocardiographic P Wave

Persistently high incidence of postcoronary bypass atrial fibrillation: possible mechanisms

Contact Info

Product

Resources

About