PR-Interval Components and Atrial Fibrillation Risk (from the Atherosclerosis Risk in Communities Study) - 18/04/17
, M. Benjamin Shoemaker, MD, MSCI c, Lin Y. Chen, MD, MS d, Alvaro Alonso, MD, PhD e, S. Patrick Whalen, MD a, Elsayed Z. Soliman, MD, MSc, MS a, fAbstract |
Reports on the association between the PR-interval and atrial fibrillation (AF) are conflicting. We hypothesized that inconsistencies stem from that fact that the PR-interval represents a composite of several distinct components. We examined the associations of the PR-interval and its components (P-wave onset to P-wave peak duration, P-wave peak to P-wave end duration, and PR-segment) with incident AF in 14,924 participants (mean age 54 ± 5.8 years; 26% black; 55% women) from the Atherosclerosis Risk In Communities study. The PR-interval and its components were automatically measured at baseline (1987 to 1989) from standard 12-lead electrocardiograms. PR-interval >200 ms was considered prolonged and values above the ninety-fifth percentile defined abnormal PR-interval components. AF was ascertained during follow-up through December 31, 2010. Over a median follow-up of 21.2 years, 1,985 participants (13%) developed AF. Prolonged PR-interval was associated with an increased risk of AF (hazard ratio [HR] 1.19, 95% confidence interval [CI] 1.02 to 1.40). However, PR-interval components showed varying levels of association with AF (P-wave onset to P-wave peak duration: HR 1.57, 95% CI 1.31 to 1.88; P-wave peak to P-wave end duration: HR 1.20, 95% CI 0.99 to 1.46; and PR-segment: HR 1.05, 95% CI 0.85 to 1.29). In addition, the components of the PR-interval had weak-to-moderate correlation with each other (correlation r ranged from −0.44 to 0.06). In conclusion, our findings suggest the PR-interval represents a composite of distinct components that are not uniformly associated with AF. Without considering the contribution of each component, inconsistent associations between the PR-interval and AF are inevitable.
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| Drs. Smith and O'Neal contributed equally in the writing of this manuscript. |
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| Funding: The Atherosclerosis Risk In Communities study is carried out as a collaborative study supported by Grants HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C, and HHSN268201100012C from National Heart, Lung, and Blood Institute. Dr. O'Neal is supported by the National Heart, Lung, And Blood Institute of the National Institutes of Health under Award Number F32HL134290. |
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| See page 471 for disclosure information. |
Vol 119 - N° 3
P. 466-472 - février 2017 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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