Risk of atrial fibrillation as a function of the electrocardiographic PR interval: Results from the Copenhagen ECG Study

Jonas Bille Nielsen; Adrian Pietersen; Claus Graff; Bent Lind; Johannes Jan Struijk; Morten Salling Olesen; Stig Haunsø; Thomas Aalexander Gerds; Patrick Thomas Ellinor; Lars Køber; Jesper Hastrup Svendsen; Anders Gaarsdal Holst

doi:10.1016/j.hrthm.2013.04.012

Risk of atrial fibrillation as a function of the electrocardiographic PR interval: Results from the Copenhagen ECG Study

Jonas Bille Nielsen, Adrian Pietersen, Claus Graff, Bent Lind, Johannes Jan Struijk, Morten Salling Olesen, Stig Haunsø, Thomas Aalexander Gerds, Patrick Thomas Ellinor, Lars Køber, Jesper Hastrup Svendsen, Anders Gaarsdal Holst

68 Citations (Scopus)

Abstract

Background Prolongation of the PR interval has been associated with an increased risk of incident atrial fibrillation (AF). Objective To determine if there was a nonlinear relation between PR interval duration and the risk of AF. Methods We included 288,181 individuals, corresponding to one third of the population in the greater region of Copenhagen. These individuals had a digital electrocardiogram (ECG) recorded in a general practitioner's core facility from 2001 to 2010. Data on drug use, comorbidity, and outcomes were collected from Danish registries. Results During a median follow-up period of 5.7 years, 11,087 developed AF. Having a PR interval ≥95th percentile (≥196 ms for women, ≥204 ms for men) was associated with an increased risk of AF as evidenced by a multivariable-adjusted hazard ratio (HR) of 1.18 (95% confidence interval [CI] 1.06-1.30, P =.001) for women and 1.30 (1.17-1.44, P <.001) for men compared with the respective reference groups (PR interval between 40th and 60th percentile). Having a short PR interval <5th percentile (≤121 ms for women, ≤129 ms for men) was also associated with an increased risk of AF for women (HR 1.32, 95% CI 1.12-1.56, P =.001), but this was not significant for men (HR 1.09, 95% CI 0.92-1.29, P =.33). Conclusion In this large ECG study, we found an increased risk of AF for longer PR intervals for both women and men. With respect to short PR intervals, we also observed an increased risk of AF for women.

Original language	English
Journal	Heart rhythm : the official journal of the Heart Rhythm Society
Volume	10
Issue number	9
Pages (from-to)	1249-1256
Number of pages	8
ISSN	1547-5271
DOIs	https://doi.org/10.1016/j.hrthm.2013.04.012
Publication status	Published - Sept 2013

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10.1016/j.hrthm.2013.04.012

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Nielsen, J. B., Pietersen, A., Graff, C., Lind, B., Struijk, J. J., Olesen, M. S., Haunsø, S., Gerds, T. A., Ellinor, P. T., Køber, L., Svendsen, J. H., & Holst, A. G. (2013). Risk of atrial fibrillation as a function of the electrocardiographic PR interval: Results from the Copenhagen ECG Study. Heart rhythm : the official journal of the Heart Rhythm Society, 10(9), 1249-1256. https://doi.org/10.1016/j.hrthm.2013.04.012

Risk of atrial fibrillation as a function of the electrocardiographic PR interval: Results from the Copenhagen ECG Study. / Nielsen, Jonas Bille; Pietersen, Adrian; Graff, Claus et al.
In: Heart rhythm : the official journal of the Heart Rhythm Society, Vol. 10, No. 9, 09.2013, p. 1249-1256.

Research output: Contribution to journal › Journal article › Research › peer-review

Nielsen, JB, Pietersen, A, Graff, C, Lind, B, Struijk, JJ, Olesen, MS, Haunsø, S, Gerds, TA, Ellinor, PT, Køber, L, Svendsen, JH & Holst, AG 2013, 'Risk of atrial fibrillation as a function of the electrocardiographic PR interval: Results from the Copenhagen ECG Study', Heart rhythm : the official journal of the Heart Rhythm Society, vol. 10, no. 9, pp. 1249-1256. https://doi.org/10.1016/j.hrthm.2013.04.012

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title = "Risk of atrial fibrillation as a function of the electrocardiographic PR interval: Results from the Copenhagen ECG Study",

abstract = "Background Prolongation of the PR interval has been associated with an increased risk of incident atrial fibrillation (AF). Objective To determine if there was a nonlinear relation between PR interval duration and the risk of AF. Methods We included 288,181 individuals, corresponding to one third of the population in the greater region of Copenhagen. These individuals had a digital electrocardiogram (ECG) recorded in a general practitioner's core facility from 2001 to 2010. Data on drug use, comorbidity, and outcomes were collected from Danish registries. Results During a median follow-up period of 5.7 years, 11,087 developed AF. Having a PR interval ≥95th percentile (≥196 ms for women, ≥204 ms for men) was associated with an increased risk of AF as evidenced by a multivariable-adjusted hazard ratio (HR) of 1.18 (95% confidence interval [CI] 1.06-1.30, P =.001) for women and 1.30 (1.17-1.44, P <.001) for men compared with the respective reference groups (PR interval between 40th and 60th percentile). Having a short PR interval <5th percentile (≤121 ms for women, ≤129 ms for men) was also associated with an increased risk of AF for women (HR 1.32, 95% CI 1.12-1.56, P =.001), but this was not significant for men (HR 1.09, 95% CI 0.92-1.29, P =.33). Conclusion In this large ECG study, we found an increased risk of AF for longer PR intervals for both women and men. With respect to short PR intervals, we also observed an increased risk of AF for women.",

author = "Nielsen, {Jonas Bille} and Adrian Pietersen and Claus Graff and Bent Lind and Struijk, {Johannes Jan} and Olesen, {Morten Salling} and Stig Hauns{\o} and Gerds, {Thomas Aalexander} and Ellinor, {Patrick Thomas} and Lars K{\o}ber and Svendsen, {Jesper Hastrup} and Holst, {Anders Gaarsdal}",

year = "2013",

month = sep,

doi = "10.1016/j.hrthm.2013.04.012",

language = "English",

volume = "10",

pages = "1249--1256",

journal = "Heart rhythm : the official journal of the Heart Rhythm Society",

issn = "1547-5271",

publisher = "Elsevier",

number = "9",

}

TY - JOUR

T1 - Risk of atrial fibrillation as a function of the electrocardiographic PR interval

T2 - Results from the Copenhagen ECG Study

AU - Nielsen, Jonas Bille

AU - Pietersen, Adrian

AU - Graff, Claus

AU - Lind, Bent

AU - Struijk, Johannes Jan

AU - Olesen, Morten Salling

AU - Haunsø, Stig

AU - Gerds, Thomas Aalexander

AU - Ellinor, Patrick Thomas

AU - Køber, Lars

AU - Svendsen, Jesper Hastrup

AU - Holst, Anders Gaarsdal

PY - 2013/9

Y1 - 2013/9

N2 - Background Prolongation of the PR interval has been associated with an increased risk of incident atrial fibrillation (AF). Objective To determine if there was a nonlinear relation between PR interval duration and the risk of AF. Methods We included 288,181 individuals, corresponding to one third of the population in the greater region of Copenhagen. These individuals had a digital electrocardiogram (ECG) recorded in a general practitioner's core facility from 2001 to 2010. Data on drug use, comorbidity, and outcomes were collected from Danish registries. Results During a median follow-up period of 5.7 years, 11,087 developed AF. Having a PR interval ≥95th percentile (≥196 ms for women, ≥204 ms for men) was associated with an increased risk of AF as evidenced by a multivariable-adjusted hazard ratio (HR) of 1.18 (95% confidence interval [CI] 1.06-1.30, P =.001) for women and 1.30 (1.17-1.44, P <.001) for men compared with the respective reference groups (PR interval between 40th and 60th percentile). Having a short PR interval <5th percentile (≤121 ms for women, ≤129 ms for men) was also associated with an increased risk of AF for women (HR 1.32, 95% CI 1.12-1.56, P =.001), but this was not significant for men (HR 1.09, 95% CI 0.92-1.29, P =.33). Conclusion In this large ECG study, we found an increased risk of AF for longer PR intervals for both women and men. With respect to short PR intervals, we also observed an increased risk of AF for women.

AB - Background Prolongation of the PR interval has been associated with an increased risk of incident atrial fibrillation (AF). Objective To determine if there was a nonlinear relation between PR interval duration and the risk of AF. Methods We included 288,181 individuals, corresponding to one third of the population in the greater region of Copenhagen. These individuals had a digital electrocardiogram (ECG) recorded in a general practitioner's core facility from 2001 to 2010. Data on drug use, comorbidity, and outcomes were collected from Danish registries. Results During a median follow-up period of 5.7 years, 11,087 developed AF. Having a PR interval ≥95th percentile (≥196 ms for women, ≥204 ms for men) was associated with an increased risk of AF as evidenced by a multivariable-adjusted hazard ratio (HR) of 1.18 (95% confidence interval [CI] 1.06-1.30, P =.001) for women and 1.30 (1.17-1.44, P <.001) for men compared with the respective reference groups (PR interval between 40th and 60th percentile). Having a short PR interval <5th percentile (≤121 ms for women, ≤129 ms for men) was also associated with an increased risk of AF for women (HR 1.32, 95% CI 1.12-1.56, P =.001), but this was not significant for men (HR 1.09, 95% CI 0.92-1.29, P =.33). Conclusion In this large ECG study, we found an increased risk of AF for longer PR intervals for both women and men. With respect to short PR intervals, we also observed an increased risk of AF for women.

U2 - 10.1016/j.hrthm.2013.04.012

DO - 10.1016/j.hrthm.2013.04.012

M3 - Journal article

C2 - 23608590

SN - 1547-5271

VL - 10

SP - 1249

EP - 1256

JO - Heart rhythm : the official journal of the Heart Rhythm Society

JF - Heart rhythm : the official journal of the Heart Rhythm Society

IS - 9

ER -

Risk of atrial fibrillation as a function of the electrocardiographic PR interval: Results from the Copenhagen ECG Study

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