P-wave duration and the risk of atrial fibrillation: Results from the Copenhagen ECG Study

TY - JOUR

T1 - P-wave duration and the risk of atrial fibrillation

T2 - Results from the Copenhagen ECG Study

AU - Nielsen, Jonas B

AU - Kühl, Jørgen T

AU - Pietersen, Adrian

AU - Graff, Claus

AU - Lind, Bent

AU - Struijk, Johannes J

AU - Olesen, Morten S

AU - Sinner, Moritz F

AU - Bachmann, Troels N

AU - Haunsø, Stig

AU - Nordestgaard, Børge G

AU - Ellinor, Patrick T

AU - Svendsen, Jesper H

AU - Kofoed, Klaus F

AU - Køber, Lars

AU - Holst, Anders G

N1 - Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

PY - 2015/9/1

Y1 - 2015/9/1

N2 - BACKGROUND: Results on the association between P-wave duration and the risk of atrial fibrillation (AF) are conflicting.OBJECTIVE: The purpose of this study was to obtain a detailed description of the relationship between P-wave duration and the risk of AF.METHODS: Using computerized analysis of electrocardiograms from a large primary care population, we evaluated the association between P-wave duration and the risk of AF. Secondary end-points were death from cardiovascular causes and putative ischemic stroke. Data on drug use, comorbidity, and outcomes were collected from administrative registries.RESULTS: A total of 285,933 individuals were included. During median follow-up period of 6.7 years, 9550 developed AF, 9371 died of a cardiovascular cause, and 8980 had a stroke. Compared with the reference group (100-105 ms), individuals with very short (≤89 ms; hazard ratio [HR] 1.60, 95% confidence interval [CI] 1.41-1.81), intermediate (112-119 ms; HR 1.22, 95% CI 1.13-1.31), long (120-129 ms; HR 1.50, 95% CI 1.39-1.62), and very long P-wave duration (≥130 ms; HR 2.06, 95% CI 1.89-2.23) had an increased risk of incident AF. With respect to death from cardiovascular causes, we found an increased risk for very short (≤89 ms; HR 1.20, 95% CI 1.06-1.34), long (120-129 ms; HR 1.11, 95% CI 1.04-1.19), and very long P-wave duration (≥130 ms; HR 1.30, 95% CI 1.21-1.40) compared with the reference group (106-111 ms). Similar but weaker associations were found between P-wave duration and the risk of putative ischemic stroke.CONCLUSION: In a large primary care population we found both short and long P-wave duration to be robustly associated with an increased risk of AF.

AB - BACKGROUND: Results on the association between P-wave duration and the risk of atrial fibrillation (AF) are conflicting.OBJECTIVE: The purpose of this study was to obtain a detailed description of the relationship between P-wave duration and the risk of AF.METHODS: Using computerized analysis of electrocardiograms from a large primary care population, we evaluated the association between P-wave duration and the risk of AF. Secondary end-points were death from cardiovascular causes and putative ischemic stroke. Data on drug use, comorbidity, and outcomes were collected from administrative registries.RESULTS: A total of 285,933 individuals were included. During median follow-up period of 6.7 years, 9550 developed AF, 9371 died of a cardiovascular cause, and 8980 had a stroke. Compared with the reference group (100-105 ms), individuals with very short (≤89 ms; hazard ratio [HR] 1.60, 95% confidence interval [CI] 1.41-1.81), intermediate (112-119 ms; HR 1.22, 95% CI 1.13-1.31), long (120-129 ms; HR 1.50, 95% CI 1.39-1.62), and very long P-wave duration (≥130 ms; HR 2.06, 95% CI 1.89-2.23) had an increased risk of incident AF. With respect to death from cardiovascular causes, we found an increased risk for very short (≤89 ms; HR 1.20, 95% CI 1.06-1.34), long (120-129 ms; HR 1.11, 95% CI 1.04-1.19), and very long P-wave duration (≥130 ms; HR 1.30, 95% CI 1.21-1.40) compared with the reference group (106-111 ms). Similar but weaker associations were found between P-wave duration and the risk of putative ischemic stroke.CONCLUSION: In a large primary care population we found both short and long P-wave duration to be robustly associated with an increased risk of AF.

KW - Adult

KW - Aged

KW - Atrial Fibrillation

KW - Brain Ischemia

KW - Denmark

KW - Electrocardiography

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Incidence

KW - Male

KW - Middle Aged

KW - Registries

KW - Risk Assessment

KW - Risk Factors

KW - Survival Rate

KW - Time Factors

KW - Tomography, X-Ray Computed

U2 - 10.1016/j.hrthm.2015.04.026

DO - 10.1016/j.hrthm.2015.04.026

M3 - Journal article

C2 - 25916567

SN - 1547-5271

VL - 12

SP - 1887

EP - 1895

JO - Heart Rhythm

JF - Heart Rhythm

IS - 9

ER -