Nielsen Jonas B, Kühl Jørgen T, Pietersen Adrian, Graff Claus, Lind Bent, Struijk Johannes J, Olesen Morten S, Sinner Moritz F, Bachmann Troels N, Haunsø Stig, Nordestgaard Børge G, Ellinor Patrick T, Svendsen Jesper H, Kofoed Klaus F, Køber Lars, Holst Anders G
Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), Copenhagen, Denmark; Laboratory for Molecular Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
Heart Rhythm. 2015 Sep;12(9):1887-95. doi: 10.1016/j.hrthm.2015.04.026. Epub 2015 Apr 23.
Results on the association between P-wave duration and the risk of atrial fibrillation (AF) are conflicting.
The purpose of this study was to obtain a detailed description of the relationship between P-wave duration and the risk of AF.
Using computerized analysis of electrocardiograms from a large primary care population, we evaluated the association between P-wave duration and the risk of AF. Secondary end-points were death from cardiovascular causes and putative ischemic stroke. Data on drug use, comorbidity, and outcomes were collected from administrative registries.
A total of 285,933 individuals were included. During median follow-up period of 6.7 years, 9550 developed AF, 9371 died of a cardiovascular cause, and 8980 had a stroke. Compared with the reference group (100-105 ms), individuals with very short (≤89 ms; hazard ratio [HR] 1.60, 95% confidence interval [CI] 1.41-1.81), intermediate (112-119 ms; HR 1.22, 95% CI 1.13-1.31), long (120-129 ms; HR 1.50, 95% CI 1.39-1.62), and very long P-wave duration (≥130 ms; HR 2.06, 95% CI 1.89-2.23) had an increased risk of incident AF. With respect to death from cardiovascular causes, we found an increased risk for very short (≤89 ms; HR 1.20, 95% CI 1.06-1.34), long (120-129 ms; HR 1.11, 95% CI 1.04-1.19), and very long P-wave duration (≥130 ms; HR 1.30, 95% CI 1.21-1.40) compared with the reference group (106-111 ms). Similar but weaker associations were found between P-wave duration and the risk of putative ischemic stroke.
In a large primary care population we found both short and long P-wave duration to be robustly associated with an increased risk of AF.
P波时限与心房颤动（AF）风险之间的关联结果存在矛盾。
本研究旨在详细描述P波时限与AF风险之间的关系。
通过对大量基层医疗人群的心电图进行计算机分析，我们评估了P波时限与AF风险之间的关联。次要终点为心血管原因导致的死亡和疑似缺血性卒中。药物使用、合并症和结局数据从行政登记处收集。
共纳入285,933人。在中位随访期6.7年期间，9550人发生AF，9371人死于心血管原因，8980人发生卒中。与参照组（100 - 105毫秒）相比，P波时限极短（≤89毫秒；风险比[HR] 1.60，95%置信区间[CI] 1.41 - 1.81）、中等（112 - 119毫秒；HR 1.22，95% CI 1.13 - 1.31）、长（120 - 129毫秒；HR 1.50，95% CI 1.39 - 1.62）和极长（≥130毫秒；HR 2.06，95% CI 1.89 - 2.23）的个体发生AF的风险增加。关于心血管原因导致的死亡，我们发现与参照组（106 - 111毫秒）相比，P波时限极短（≤89毫秒；HR 1.20，95% CI 1.06 - 1.34）、长（120 - 129毫秒；HR 1.11，95% CI 1.04 - 1.19）和极长（≥130毫秒；HR 1.30，95% CI 1.21 - 1.40）的个体风险增加。在P波时限与疑似缺血性卒中风险之间发现了相似但较弱的关联。
在大量基层医疗人群中，我们发现P波时限过短和过长均与AF风险增加密切相关。
