Electrocardiographic P-wave Parameters and Lifetime Atrial Fibrillation Risk: A Multi-Cohort Study.

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart rhythm Pub Date : 2025-04-04 DOI:10.1016/j.hrthm.2025.03.2004

Matthew W Segar, Kaleb Lambeth, Anna Rosenblatt, Robert D Paisley, Abdi Rasekh, Joanna Molina-Razavi, Mehdi Razavi, Ambarish Pandey, Mohammad Saeed

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引用次数: 0

Abstract

Background: The P-wave on surface electrocardiogram (ECG) undergoes characteristic changes prior to developing atrial fibrillation (AF). However, the relationship between P-wave parameters and lifetime risk of AF remains poorly characterized.

Objective: To determine the association between baseline ECG P-wave parameters and lifetime risk of AF.

Methods: We conducted a pooled analysis of 25,508 participants from four prospective cohort studies. P-wave parameters were analyzed based on contemporary consensus criteria, including advanced interatrial block (IAB), P-terminal force in V1, P-wave axis, P-wave voltage in lead I, P-wave area in lead II, and P-wave dispersion. Using a modified Kaplan-Meier analysis accounting for competing risks, we calculated lifetime risk of AF stratified by individual and cumulative ECG abnormalities.

Results: During follow-up, 2,877 participants (11.3%) developed AF. At index age 45, IAB showed the strongest association with lifetime AF risk (35.4% vs 23.9%), followed by lead II area (30.0% vs 24.6%) and P-wave dispersion >70ms (28.8% vs 23.6%). A dose-response relationship was observed with cumulative abnormalities: participants with 0-1 abnormalities had a lifetime risk of 222.9%, increasing to 27.0%, 30.7%, and 35.7% for 2, 3, and 4+ abnormalities, respectively. Participants with 4+ ECG abnormalities lived an average of 17.1 years free of AF compared to 21.7 years for those with none.

Conclusions: Multiple P-wave parameters are associated with increased lifetime risk of AF, with a strong dose-response relationship for cumulative abnormalities. These findings suggest that comprehensive ECG analysis may enhance long-term AF risk assessment.

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心电图p波参数与终生房颤风险：一项多队列研究。

背景：体表心电图（ECG）的p波在发生心房颤动（AF）之前发生特征性变化。然而，p波参数与房颤终生风险之间的关系尚不清楚。目的：确定基线心电图p波参数与af终生风险之间的关系。方法：我们对来自四项前瞻性队列研究的25,508名参与者进行了汇总分析。p波参数根据当代共识标准进行分析，包括高级心房间传导阻滞（IAB）、V1的p端力、p波轴、导联I的p波电压、导联II的p波面积和p波弥散度。使用考虑竞争风险的修正Kaplan-Meier分析，我们计算了按个体和累积ECG异常分层的AF终生风险。结果：随访期间，2877人（11.3%）发生房颤。在指标年龄45岁时，IAB与终生房颤风险的相关性最强（35.4%比23.9%），其次是II导联面积（30.0%比24.6%）和p波弥散度bbb70ms（28.8%比23.6%）。在累积异常中观察到剂量-反应关系：0-1异常的参与者终生风险为222.9%，2、3和4+异常分别增加到27.0%、30.7%和35.7%。4+ ECG异常的参与者无房颤的平均寿命为17.1年，而无心电图异常的参与者为21.7年。结论：多个p波参数与房颤终生风险增加相关，且累积异常具有很强的剂量-反应关系。这些发现表明，全面的心电图分析可以提高长期房颤风险评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Heart rhythm 医学-心血管系统

CiteScore

10.50

自引率

5.50%

发文量

1465

审稿时长

24 days

期刊介绍： HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability. HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community. The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.