Yang Na, Li Xiaoyan, Wu Bo, Dai Longhao, Yang Shaobin, Zhang Qinning, Jia Shaobin
School of Clinical Medicine, Clinical Medicine, Ningxia Medical University, Yinchuan, People's Republic of China.
Resident of Cardiology, Department of Heart Centre, Wuzhong People's Hospital, Wuzhong, People's Republic of China.
Ann Noninvasive Electrocardiol. 2025 Jan;30(1):e70041. doi: 10.1111/anec.70041.
After acute myocardial infarction (AMI), it is common to observe new-onset atrial fibrillation (NOAF), which is often related to a negative prognosis. Some P-wave variables (P-wave duration [PWD], P-wave amplitude, and interatrial block [IAB]), reflecting the process of electrical and structural remodeling, could predict the risk of atrial fibrillation (AF). This study aimed to assess the predictive value of P-wave variables for post-AMI NOAF.
We retrospectively analyzed 1581 AMI patients with no prior AF, using follow-up data from January 2023 to January 2024. P-wave variables were measured, and patients were grouped based on in-hospital NOAF occurrence.
Overall, 164 (10.3%) of the 1581 patients had NOAF. The age (61.08 ± 12.02 vs. 67.91 ± 11.60, p < 0.001), left atrial size (36.31 ± 3.94 vs. 39.12 ± 5.51, p < 0.001), Brain Natriuretic Peptide (1588.45 ± 3346.18 vs. 3864.39 ± 6251.92, p < 0.001), P-wave variables (PWD: 102.78 ± 12.56 vs. 117.88 ± 18.81, p < 0.001; P-wave amplitude: 0.12 ± 0.04 vs. 0.13 ± 0.04, p = 0.041; interatrial block: 89.6% vs. 10.3%, p < 0.001), congestive heart failure (4.7% vs. 23.2%, p < 0.001), and Killip > 1 (25.3% vs. 55.5%, p < 0.001) showed significant differences between the non-AF and NOAF groups. P-wave variables were significantly associated with an increased risk of NOAF in multivariable regression analysis.
The addition of P-wave variables to AF risk factors from literature and guidelines significantly improved NOAF risk discrimination. P-wave variables were strongly associated with NOAF after AMI. Adding these variables enhanced the predictive performance for post-AMI NOAF.
急性心肌梗死（AMI）后，新发心房颤动（NOAF）很常见，且常与不良预后相关。一些反映电重构和结构重构过程的P波变量（P波时限[PWD]、P波振幅和心房内传导阻滞[IAB]）可预测心房颤动（AF）的风险。本研究旨在评估P波变量对AMI后NOAF的预测价值。
我们回顾性分析了1581例既往无AF的AMI患者，使用2023年1月至2024年1月的随访数据。测量P波变量，并根据住院期间NOAF的发生情况对患者进行分组。
总体而言，1581例患者中有164例（10.3%）发生了NOAF。非AF组和NOAF组在年龄（61.08±12.02 vs. 67.91±11.60，p< 0.001）、左心房大小（36.31±3.94 vs. 39.12±5.51，p< 0.001）、脑钠肽（1588.45±3346.18 vs. 3864.39±6251.92，p< 0.001）、P波变量（PWD：102.78±12.56 vs. 117.88±18.81，p< 0.001；P波振幅：0.12±0.04 vs. 0.13±0.04，p= 0.041；心房内传导阻滞：89.6% vs. 10.3%，p< 0.001）、充血性心力衰竭（4.7% vs. 23.2%，p< 0.001）和Killip>1（25.3% vs. 55.5%，p< 0.001）方面存在显著差异。在多变量回归分析中，P波变量与NOAF风险增加显著相关。
将P波变量添加到文献和指南中的AF风险因素中，可显著改善NOAF风险判别。P波变量与AMI后的NOAF密切相关。添加这些变量可提高对AMI后NOAF的预测性能。
