Massó-van Roessel Albert, Escobar-Robledo Luis Alberto, Dégano Irene R, Grau María, Sala Joan, Ramos Rafel, Marrugat Jaume, Bayés de Luna Antoni, Elosua Roberto
Instituto Catalán de Ciencias Cardiovasculares, Barcelona, Spain.
Grupo de Epidemiología y Genética Cardiovascular, Grupo del Estudio REGICOR, Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, Spain; CIBER de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Barcelona, Spain.
Rev Esp Cardiol (Engl Ed). 2017 Oct;70(10):841-847. doi: 10.1016/j.rec.2017.02.019. Epub 2017 Mar 18.
Atrial fibrillation (AF) is the most common clinically significant cardiac arrhythmia. P-wave duration and interatrial blocks (IAB) have been reported to be associated with AF. Our aim was to determine the individual and combined association of P-wave duration and advanced IAB morphology with AF.
We designed an age-, sex-, and survey-matched case-control study nested in a population-based cohort (REGICOR: REgistre GIroní del COR). Two different surveys recruited a total of 9380 participants from 1999 to 2005; all participants were invited to a second examination between 2009 and 2013. For the present study, we selected participants aged 25 to 79 years with follow-up through the end of the study. All electrocardiograms were analyzed by 2 observers to determine P-wave duration and morphology (normal, partial, or advanced IAB).
The median follow-up was 7.12 years. Eighty participants presented with AF, had a legible baseline electrocardiogram, and were included in the study, along with 160 controls. P-wave duration and the presence of partial or advanced IAB were associated with AF. When P-wave duration and morphology were considered together, only P-wave duration (≥ 110 milliseconds) showed an independent and strong association with AF. The odds ratio for AF of P-wave duration between 110-119, 120-129 and ≥ 130 milliseconds vs < 110 milliseconds were 5.33; 95%CI, 1.74-16.33, 5.08; 95%CI, 1.73-14.90 and 5.44; 95%CI, 1.95-15.15, respectively.
A P-wave longer than 110 milliseconds increases the risk of AF. Advanced IAB morphology did not seem to provide an additional AF risk beyond that of P-wave duration.
心房颤动（AF）是临床上最常见的具有重要意义的心律失常。据报道，P波时限和心房内阻滞（IAB）与AF有关。我们的目的是确定P波时限和晚期IAB形态与AF的个体及联合关联。
我们设计了一项年龄、性别和调查匹配的病例对照研究，该研究嵌套于一项基于人群的队列研究（REGICOR：加泰罗尼亚心血管注册研究）中。1999年至2005年期间，两项不同的调查共招募了9380名参与者；所有参与者均被邀请在2009年至2013年期间进行第二次检查。在本研究中，我们选择了年龄在25至79岁之间且随访至研究结束的参与者。所有心电图均由两名观察者进行分析，以确定P波时限和形态（正常、部分或晚期IAB）。
中位随访时间为7.12年。80名出现AF、有清晰基线心电图且被纳入研究的参与者，以及160名对照者。P波时限以及部分或晚期IAB的存在与AF有关。当同时考虑P波时限和形态时，只有P波时限（≥110毫秒）显示出与AF有独立且强烈的关联。P波时限在110 - 119、120 - 129和≥130毫秒与<110毫秒相比，AF的比值比分别为5.33；95%CI，1.74 - 16.33、5.08；95%CI，1.73 - 14.90和5.44；95%CI，1.95 - 15.15。
P波时限超过110毫秒会增加AF的风险。晚期IAB形态似乎并未提供超出P波时限之外的额外AF风险。
