University Hospital St Josef Hospital, Cardiology and Rhythmology, Ruhr University, Bochum, Germany.
University Hospital Bergmannsheil, Cardiology and Angiology, Ruhr University, Bochum, Germany.
Ann Noninvasive Electrocardiol. 2021 Sep;26(5):e12854. doi: 10.1111/anec.12854. Epub 2021 May 7.
Several P-wave indices are associated with the development of atrial fibrillation (AF). However, previous studies have been limited in their ability to reliably diagnose episodes of AF. Implantable loop recorders allow long-term, continuous, and therefore more reliable detection of AF.
The aim of this study is to identify and evaluate ECG parameters for predicting AF by analyzing patients with loop recorders.
This study included 366 patients (mean age 62 ± 16 years, mean LVEF 61 ± 6%, 175 women) without AF who underwent loop recorder implantation between 2010-2020. Patients were followed up on a 3 monthly outpatient interval.
During a follow-up of 627 ± 409 days, 75 patients (20%) reached the primary study end point (first detection of AF). Independent predictors of AF were as follows: age ≥68 years (hazard risk [HR], 2.66; 95% confidence interval [CI], 1.668-4.235; p < .001), P-wave amplitude in II <0.1 mV (HR, 2.11; 95% CI, 1.298-3.441; p = .003), P-wave terminal force in V ≤ -4000 µV × ms (HR, 5.3; 95% CI, 3.249-8.636; p < .001, and advanced interatrial block (HR, 5.01; 95% CI, 2.638-9.528; p < .001). Our risk stratification model based on these independent predictors separated patients into 4 groups with high (70%), intermediate high (41%), intermediate low (18%), and low (4%) rates of AF.
Our study indicated that P-wave indices are suitable for predicting AF episodes. Furthermore, it is possible to stratify patients into risk groups for AF using simple ECG parameters, which is particularly important for patients with cryptogenic stroke.
几个 P 波指数与心房颤动（AF）的发生有关。然而，之前的研究在可靠诊断 AF 发作方面能力有限。植入式环路记录器可实现 AF 的长期、连续、因此更可靠的检测。
本研究旨在通过分析环路记录器患者，确定和评估用于预测 AF 的心电图参数。
这项研究纳入了 2010 年至 2020 年间接受环路记录器植入的 366 名（平均年龄 62 ± 16 岁，平均 LVEF 61 ± 6%，女性 175 名）无 AF 的患者。患者以每 3 个月的门诊间隔进行随访。
在 627 ± 409 天的随访期间，75 名患者（20%）达到了主要研究终点（首次检测到 AF）。AF 的独立预测因素如下：年龄≥68 岁（风险比 [HR]，2.66；95%置信区间 [CI]，1.668-4.235；p < 0.001），II 导联 P 波振幅<0.1 mV（HR，2.11；95%CI，1.298-3.441；p = 0.003），V 导联 P 波终末电势≤-4000 µV×ms（HR，5.3；95%CI，3.249-8.636；p < 0.001）和高级房内阻滞（HR，5.01；95%CI，2.638-9.528；p < 0.001）。我们基于这些独立预测因素的风险分层模型将患者分为 4 组，AF 发生率分别为高（70%）、中高（41%）、中低（18%）和低（4%）。
我们的研究表明 P 波指数适用于预测 AF 发作。此外，使用简单的心电图参数将患者分层为 AF 风险组是可能的，这对于隐源性卒中患者尤为重要。
