Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 North Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA.
Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, 920-8641, Japan.
Heart Vessels. 2021 Sep;36(9):1401-1409. doi: 10.1007/s00380-021-01805-2. Epub 2021 Feb 17.
Some previous studies demonstrated that first-degree atrioventricular block (f-AVB) was associated with incident atrial fibrillation (AF), while evidence is scarce regarding the association between f-AVB and incident AF in older populations. Therefore, we sought to investigate the association of f-AVB with incident AF in the population predominantly including participants aged ≥ 60 years. Eligible participants were residents in Kanazawa City, Japan aged ≥ 40 years who underwent 12-lead ECG at the National Japanese Health Check-up in 2013. Participants with AF detected at the baseline exam and those without adequate follow-up were excluded. f-AVB was defined as PR interval ≥ 220 ms based on the Minnesota code (6-3). The cumulative incidence of AF was estimated by the Kaplan-Meier curve analysis, and statistical significance was evaluated by the Log-rank test. Unadjusted and adjusted hazard ratios (HRs) were computed by Cox proportional hazard models. HRs were adjusted for conventional risk factors for AF. 37,730 participants (mean age, 72.3 ± 9.6 years; male, 37%) were included. Baseline f-AVB was observed in 667 (1.8%) participants. During the median follow-up period of 5 years (interquartile range, 4.0-5.0 years), 691 cases of incident AF were observed. A 5-year cumulative incidence of AF was significantly higher in f-AVB (+) group compared with f-AVB (-) group (6.8% vs 2.1%, p < 0.01). In the fully adjusted model, f-AVB was significantly associated with incident AF (HR, 1.75; 95% confidence interval 1.25-2.45; p value < 0.01). f-AVB was independently associated with incident AF in the population predominantly including participants aged ≥ 60 years.
一些先前的研究表明，一度房室传导阻滞（f-AVB）与心房颤动（AF）的发生有关，而关于老年人中 f-AVB 与 AF 发生之间的关系的证据很少。因此，我们试图研究在主要包括年龄≥60 岁的参与者的人群中，f-AVB 与 AF 发生之间的关联。符合条件的参与者是日本金泽市的居民，年龄≥40 岁，他们在 2013 年接受了国家日本健康检查的 12 导联心电图检查。在基线检查中发现有 AF 的参与者和随访时间不足的参与者被排除在外。f-AVB 根据明尼苏达州编码（6-3）定义为 PR 间隔≥220ms。通过 Kaplan-Meier 曲线分析估计 AF 的累积发生率，并通过对数秩检验评估统计学意义。通过 Cox 比例风险模型计算未经调整和调整后的危险比（HR）。HR 调整了 AF 的常规危险因素。共有 37730 名参与者（平均年龄 72.3±9.6 岁；男性占 37%）入选。基线 f-AVB 见于 667 名（1.8%）参与者。在中位随访 5 年（四分位间距，4.0-5.0 年）期间，观察到 691 例新发 AF。与 f-AVB（-）组相比，f-AVB（+）组的 5 年累积 AF 发生率显著更高（6.8%比 2.1%，p<0.01）。在完全调整的模型中，f-AVB 与新发 AF 显著相关（HR，1.75；95%置信区间 1.25-2.45；p 值<0.01）。在主要包括年龄≥60 岁的参与者的人群中，f-AVB 与新发 AF 独立相关。
