Department of Medical Sciences, Uppsala University.
Int Heart J. 2022 Jul 30;63(4):700-707. doi: 10.1536/ihj.21-797. Epub 2022 Jul 14.
Atrial fibrillation (AF) is common and increases the risk for stroke and heart failure (HF). The early identification of patients at risk may prevent the development of AF and improve prognosis. This study, therefore, aimed to test the effect of the association between P-wave and PR-interval on the ECG and incident AF.The PIVUS (Prospective Investigation of the Vasculature in Uppsala Seniors) study (1016 individuals all aged 70 years; 50% women) was used to identify whether the ECG variables P-wave duration (Pdur) and PR-duration in lead V1 were related to new-onset AF. Exclusion criteria were prevalent AF, QRS-duration ≥ 130 milliseconds (msec), atrial tachyarrhythmias and implanted pacemaker/defibrillator. Cox proportional-hazards models were used for analyses. Adjustments were made for gender, RR-interval, beta-blocking agents, systolic blood pressure, body mass index, and smoking.Of 877 subjects at risk, 189 individuals developed AF during a 15-year follow-up. There was a U-shaped relationship between the Pdur and incident AF (P = 0.017) following multiple adjustment. Values below 60 msec were significantly associated with incident AF, with a hazard ratio of 1.55 (95% confidence interval 1.15-2.09) for a Pdur ≤ 42 msec. There was no significant relationship between incident AF and the PR-interval.A short Pdur derived from the ECG in V1 may be a useful marker for new-onset AF, enabling the early identification of at-risk patients.
心房颤动（AF）很常见，会增加中风和心力衰竭（HF）的风险。早期识别高危患者可能预防 AF 的发生并改善预后。因此，本研究旨在检验心电图 P 波和 PR 间期与 AF 发生之间的相关性对预测 AF 发生的效果。使用 PIVUS（乌普萨拉老年人血管前瞻性研究）研究（1016 名年龄均为 70 岁的个体；女性占 50%）来确定心电图变量 V1 导联 P 波持续时间（Pdur）和 PR 持续时间是否与新发 AF 相关。排除标准为先前存在的 AF、QRS 持续时间≥130 毫秒（msec）、房性心动过速和植入式起搏器/除颤器。采用 Cox 比例风险模型进行分析。调整了性别、RR 间隔、β受体阻滞剂、收缩压、体重指数和吸烟因素。在 877 名高危患者中，189 名在 15 年随访期间发生了 AF。在进行多次调整后，Pdur 与新发 AF 之间呈 U 形关系（P=0.017）。Pdur 值低于 60 msec 与新发 AF 显著相关，Pdur ≤ 42 msec 时的风险比为 1.55（95%置信区间 1.15-2.09）。PR 间期与新发 AF 之间无显著关系。V1 心电图上的短 Pdur 可能是新发 AF 的有用标志物，可早期识别高危患者。
