P‐wave indices as predictors of atrial fibrillation
Abstract Background P‐wave duration (PDURATION) and P‐wave area (PAREA) have been linked to risk of atrial fibrillation (AF), but they do not improve the efficacy of Framingham AF risk score. We suggest the incorporation of both variables in one index, the P‐wave area/P‐wave duration (PAREA/DURATION...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-09-01
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| Series: | Annals of Noninvasive Electrocardiology |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/anec.12751 |
| _version_ | 1797802937982910464 |
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| author | Maria Uggen Rasmussen Preman Kumarathurai Andreas Fabricius‐Bjerre Bjørn Strøier Larsen Helena Domínguez Ulla Davidsen Thomas Alexander Gerds Jørgen K. Kanters Ahmad Sajadieh |
| author_facet | Maria Uggen Rasmussen Preman Kumarathurai Andreas Fabricius‐Bjerre Bjørn Strøier Larsen Helena Domínguez Ulla Davidsen Thomas Alexander Gerds Jørgen K. Kanters Ahmad Sajadieh |
| author_sort | Maria Uggen Rasmussen |
| collection | DOAJ |
| description | Abstract Background P‐wave duration (PDURATION) and P‐wave area (PAREA) have been linked to risk of atrial fibrillation (AF), but they do not improve the efficacy of Framingham AF risk score. We suggest the incorporation of both variables in one index, the P‐wave area/P‐wave duration (PAREA/DURATION) index, which may be considered an expression of the average amplitude of the P wave that reflects aspects of P‐wave morphology. Objective To assess the prognostic value of P‐wave area/P‐wave duration index (PAREA/DURATION index) in lead II together with other P‐wave indices (PWIs) in incidence of AF in the Copenhagen Holter Study. Methods The study included 632 men and women, between 55 and 75 years with no apparent heart disease or AF. Baseline standard 12‐lead Electrocardiography (ECGs) were analyzed manually. Results The median follow‐up time was 14.7 (14.5;14.9) years. A total of 68 cases of AF and 233 cases of death were recorded. The restricted cubic spline method showed a U‐shaped association between PAREA/DURATION and rate of AF. The lowest quintile of PAREA/DURATION index in lead II was associated with increased rate of AF, HR 2.80 (1.64–4.79). The addition of the new index to the Framingham model for AF improved the model in this population. The PAREA in lead II in its lowest quintile was also associated with increased rate of AF, HR 2.16 (1.25–3.75), but did not improve the Framingham model. PDURATION and P‐wave terminal force (PTF) were not significantly associated with AF. Conclusion A flat P wave as expressed by a small PAREA/DURATION index in lead II is associated with increased rate of incident AF beyond known AF risk factors. |
| first_indexed | 2024-03-13T05:13:19Z |
| format | Article |
| id | doaj.art-a78129ea52674d3a8afd0636a3875658 |
| institution | Directory Open Access Journal |
| issn | 1082-720X 1542-474X |
| language | English |
| last_indexed | 2024-03-13T05:13:19Z |
| publishDate | 2020-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Noninvasive Electrocardiology |
| spelling | doaj.art-a78129ea52674d3a8afd0636a38756582023-06-16T04:06:08ZengWileyAnnals of Noninvasive Electrocardiology1082-720X1542-474X2020-09-01255n/an/a10.1111/anec.12751P‐wave indices as predictors of atrial fibrillationMaria Uggen Rasmussen0Preman Kumarathurai1Andreas Fabricius‐Bjerre2Bjørn Strøier Larsen3Helena Domínguez4Ulla Davidsen5Thomas Alexander Gerds6Jørgen K. Kanters7Ahmad Sajadieh8Department of Cardiology Copenhagen University Hospital of Bispebjerg Copenhagen DenmarkDepartment of Cardiology Copenhagen University Hospital of Bispebjerg Copenhagen DenmarkDepartment of Cardiology Copenhagen University Hospital of Bispebjerg Copenhagen DenmarkDepartment of Cardiology Copenhagen University Hospital of Bispebjerg Copenhagen DenmarkDepartment of Cardiology Copenhagen University Hospital of Bispebjerg Copenhagen DenmarkDepartment of Cardiology Copenhagen University Hospital of Bispebjerg Copenhagen DenmarkDepartment of Biostatistics University of Copenhagen Copenhagen DenmarkLaboratory of Experimental Cardiology Department of Biomedical Sciences University of Copenhagen Copenhagen DenmarkDepartment of Cardiology Copenhagen University Hospital of Bispebjerg Copenhagen DenmarkAbstract Background P‐wave duration (PDURATION) and P‐wave area (PAREA) have been linked to risk of atrial fibrillation (AF), but they do not improve the efficacy of Framingham AF risk score. We suggest the incorporation of both variables in one index, the P‐wave area/P‐wave duration (PAREA/DURATION) index, which may be considered an expression of the average amplitude of the P wave that reflects aspects of P‐wave morphology. Objective To assess the prognostic value of P‐wave area/P‐wave duration index (PAREA/DURATION index) in lead II together with other P‐wave indices (PWIs) in incidence of AF in the Copenhagen Holter Study. Methods The study included 632 men and women, between 55 and 75 years with no apparent heart disease or AF. Baseline standard 12‐lead Electrocardiography (ECGs) were analyzed manually. Results The median follow‐up time was 14.7 (14.5;14.9) years. A total of 68 cases of AF and 233 cases of death were recorded. The restricted cubic spline method showed a U‐shaped association between PAREA/DURATION and rate of AF. The lowest quintile of PAREA/DURATION index in lead II was associated with increased rate of AF, HR 2.80 (1.64–4.79). The addition of the new index to the Framingham model for AF improved the model in this population. The PAREA in lead II in its lowest quintile was also associated with increased rate of AF, HR 2.16 (1.25–3.75), but did not improve the Framingham model. PDURATION and P‐wave terminal force (PTF) were not significantly associated with AF. Conclusion A flat P wave as expressed by a small PAREA/DURATION index in lead II is associated with increased rate of incident AF beyond known AF risk factors.https://doi.org/10.1111/anec.12751atrial fibrillationelectrocardiographyP waveP‐wave indices |
| spellingShingle | Maria Uggen Rasmussen Preman Kumarathurai Andreas Fabricius‐Bjerre Bjørn Strøier Larsen Helena Domínguez Ulla Davidsen Thomas Alexander Gerds Jørgen K. Kanters Ahmad Sajadieh P‐wave indices as predictors of atrial fibrillation Annals of Noninvasive Electrocardiology atrial fibrillation electrocardiography P wave P‐wave indices |
| title | P‐wave indices as predictors of atrial fibrillation |
| title_full | P‐wave indices as predictors of atrial fibrillation |
| title_fullStr | P‐wave indices as predictors of atrial fibrillation |
| title_full_unstemmed | P‐wave indices as predictors of atrial fibrillation |
| title_short | P‐wave indices as predictors of atrial fibrillation |
| title_sort | p wave indices as predictors of atrial fibrillation |
| topic | atrial fibrillation electrocardiography P wave P‐wave indices |
| url | https://doi.org/10.1111/anec.12751 |
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