Risk Prediction of Atrial Fibrillation Based on Electrocardiographic Interatrial Block
BackgroundThe electrocardiographic interatrial block (IAB) has been associated with atrial fibrillation (AF). We aimed to test whether IAB can improve risk prediction of AF for the individual person. Methods and ResultsDigital ECGs of 152 759 primary care patients aged 50 to 90 years were collected...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2018-06-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.117.008247 |
| _version_ | 1819182665238052864 |
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| author | Morten W. Skov Jonas Ghouse Jørgen T. Kühl Pyotr G. Platonov Claus Graff Andreas Fuchs Peter V. Rasmussen Adrian Pietersen Børge G. Nordestgaard Christian Torp‐Pedersen Steen M. Hansen Morten S. Olesen Stig Haunsø Lars Køber Thomas A. Gerds Klaus F. Kofoed Jesper H. Svendsen Anders G. Holst Jonas B. Nielsen |
| author_facet | Morten W. Skov Jonas Ghouse Jørgen T. Kühl Pyotr G. Platonov Claus Graff Andreas Fuchs Peter V. Rasmussen Adrian Pietersen Børge G. Nordestgaard Christian Torp‐Pedersen Steen M. Hansen Morten S. Olesen Stig Haunsø Lars Køber Thomas A. Gerds Klaus F. Kofoed Jesper H. Svendsen Anders G. Holst Jonas B. Nielsen |
| author_sort | Morten W. Skov |
| collection | DOAJ |
| description | BackgroundThe electrocardiographic interatrial block (IAB) has been associated with atrial fibrillation (AF). We aimed to test whether IAB can improve risk prediction of AF for the individual person. Methods and ResultsDigital ECGs of 152 759 primary care patients aged 50 to 90 years were collected from 2001 to 2011. We identified individuals with P‐wave ≥120 ms and the presence of none, 1, 2, or 3 biphasic P‐waves in inferior leads. Data on comorbidity, medication, and outcomes were obtained from nationwide registries. We observed a dose‐response relationship between the number of biphasic P‐waves in inferior leads and the hazard of AF during follow‐up. Discrimination of the 10‐year outcome of AF, measured by time‐dependent area under the curve, was increased by 1.09% (95% confidence interval 0.43–1.74%) for individuals with cardiovascular disease at baseline (CVD) and 1.01% (95% confidence interval 0.40–1.62%) for individuals without CVD, when IAB was added to a conventional risk model for AF. The highest effect of IAB on the absolute risk of AF was observed in individuals aged 60 to 70 years with CVD. In this subgroup, the 10‐year risk of AF was 50% in those with advanced IAB compared with 10% in those with a normal P‐wave. In general, individuals with advanced IAB and no CVD had a higher risk of AF than patients with CVD and no IAB. ConclusionsIAB improves risk prediction of AF when added to a conventional risk model. Clinicians may consider monitoring patients with IAB more closely for the occurrence of AF, especially for high‐risk subgroups. |
| first_indexed | 2024-12-22T22:49:44Z |
| format | Article |
| id | doaj.art-7963d72bd1364e259fec4727803a9609 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-22T22:49:44Z |
| publishDate | 2018-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-7963d72bd1364e259fec4727803a96092022-12-21T18:09:59ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802018-06-0171110.1161/JAHA.117.008247Risk Prediction of Atrial Fibrillation Based on Electrocardiographic Interatrial BlockMorten W. Skov0Jonas Ghouse1Jørgen T. Kühl2Pyotr G. Platonov3Claus Graff4Andreas Fuchs5Peter V. Rasmussen6Adrian Pietersen7Børge G. Nordestgaard8Christian Torp‐Pedersen9Steen M. Hansen10Morten S. Olesen11Stig Haunsø12Lars Køber13Thomas A. Gerds14Klaus F. Kofoed15Jesper H. Svendsen16Anders G. Holst17Jonas B. Nielsen18Laboratory for Molecular Cardiology, The Heart Center, Rigshospitalet University of Copenhagen, DenmarkLaboratory for Molecular Cardiology, The Heart Center, Rigshospitalet University of Copenhagen, DenmarkDepartment of Cardiology, The Heart Center, Rigshospitalet University of Copenhagen, DenmarkCenter for Integrative Electrocardiography at Lund University and Arrhythmia Clinic, Skåne University Hospital, Lund, SwedenDepartment of Health Science and Technology, Aalborg University, Aalborg, DenmarkDepartment of Cardiology, The Heart Center, Rigshospitalet University of Copenhagen, DenmarkLaboratory for Molecular Cardiology, The Heart Center, Rigshospitalet University of Copenhagen, DenmarkCopenhagen General Practitioners’ Laboratory, Copenhagen, DenmarkDepartment of Clinical Biochemistry and the Copenhagen General Population Study, Herlev and Gentofte Hospital University of Copenhagen, DenmarkDepartment of Health Science and Technology, Aalborg University, Aalborg, DenmarkDepartment of Health Science and Technology, Aalborg University, Aalborg, DenmarkLaboratory for Molecular Cardiology, The Heart Center, Rigshospitalet University of Copenhagen, DenmarkLaboratory for Molecular Cardiology, The Heart Center, Rigshospitalet University of Copenhagen, DenmarkDepartment of Cardiology, The Heart Center, Rigshospitalet University of Copenhagen, DenmarkDepartment of Biostatistics, University of Copenhagen, DenmarkDepartment of Cardiology, The Heart Center, Rigshospitalet University of Copenhagen, DenmarkLaboratory for Molecular Cardiology, The Heart Center, Rigshospitalet University of Copenhagen, DenmarkLaboratory for Molecular Cardiology, The Heart Center, Rigshospitalet University of Copenhagen, DenmarkLaboratory for Molecular Cardiology, The Heart Center, Rigshospitalet University of Copenhagen, DenmarkBackgroundThe electrocardiographic interatrial block (IAB) has been associated with atrial fibrillation (AF). We aimed to test whether IAB can improve risk prediction of AF for the individual person. Methods and ResultsDigital ECGs of 152 759 primary care patients aged 50 to 90 years were collected from 2001 to 2011. We identified individuals with P‐wave ≥120 ms and the presence of none, 1, 2, or 3 biphasic P‐waves in inferior leads. Data on comorbidity, medication, and outcomes were obtained from nationwide registries. We observed a dose‐response relationship between the number of biphasic P‐waves in inferior leads and the hazard of AF during follow‐up. Discrimination of the 10‐year outcome of AF, measured by time‐dependent area under the curve, was increased by 1.09% (95% confidence interval 0.43–1.74%) for individuals with cardiovascular disease at baseline (CVD) and 1.01% (95% confidence interval 0.40–1.62%) for individuals without CVD, when IAB was added to a conventional risk model for AF. The highest effect of IAB on the absolute risk of AF was observed in individuals aged 60 to 70 years with CVD. In this subgroup, the 10‐year risk of AF was 50% in those with advanced IAB compared with 10% in those with a normal P‐wave. In general, individuals with advanced IAB and no CVD had a higher risk of AF than patients with CVD and no IAB. ConclusionsIAB improves risk prediction of AF when added to a conventional risk model. Clinicians may consider monitoring patients with IAB more closely for the occurrence of AF, especially for high‐risk subgroups.https://www.ahajournals.org/doi/10.1161/JAHA.117.008247atrial fibrillationECGepidemiologyinteratrialinteratrial blockischemic stroke |
| spellingShingle | Morten W. Skov Jonas Ghouse Jørgen T. Kühl Pyotr G. Platonov Claus Graff Andreas Fuchs Peter V. Rasmussen Adrian Pietersen Børge G. Nordestgaard Christian Torp‐Pedersen Steen M. Hansen Morten S. Olesen Stig Haunsø Lars Køber Thomas A. Gerds Klaus F. Kofoed Jesper H. Svendsen Anders G. Holst Jonas B. Nielsen Risk Prediction of Atrial Fibrillation Based on Electrocardiographic Interatrial Block Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease atrial fibrillation ECG epidemiology interatrial interatrial block ischemic stroke |
| title | Risk Prediction of Atrial Fibrillation Based on Electrocardiographic Interatrial Block |
| title_full | Risk Prediction of Atrial Fibrillation Based on Electrocardiographic Interatrial Block |
| title_fullStr | Risk Prediction of Atrial Fibrillation Based on Electrocardiographic Interatrial Block |
| title_full_unstemmed | Risk Prediction of Atrial Fibrillation Based on Electrocardiographic Interatrial Block |
| title_short | Risk Prediction of Atrial Fibrillation Based on Electrocardiographic Interatrial Block |
| title_sort | risk prediction of atrial fibrillation based on electrocardiographic interatrial block |
| topic | atrial fibrillation ECG epidemiology interatrial interatrial block ischemic stroke |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.117.008247 |
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