Details

Autor(en) / Beteiligte

• Nguyen, Kaylin T., BS
• Vittinghoff, Eric, PhD
• Dewland, Thomas A., MD
• Mandyam, Mala C., MD
• Stein, Phyllis K., PhD
• Soliman, Elsayed Z., MD
• Heckbert, Susan R., MD, PhD
• Marcus, Gregory M., MD, MAS

Titel

Electrocardiographic Predictors of Incident Atrial Fibrillation

Ist Teil von

• The American journal of cardiology, 2016-09, Vol.118 (5), p.714-719

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2016

Quelle

MEDLINE

Beschreibungen/Notizen

• Abstract Atrial fibrillation (AF) is likely secondary to multiple different pathophysiological mechanisms that are increasingly, but incompletely understood. Motivated by the hypothesis that 3 previously described electrocardiographic (ECG) predictors of AF identify distinct AF mechanisms, we sought to determine if these ECG findings independently predict incident disease. Among Cardiovascular Health Study participants without prevalent AF, we determined whether left anterior fascicular block (LAFB), a prolonged QTC , and atrial premature complexes (APCs) each predicted AF after adjusting for each other. We then calculated the attributable risk in the exposed for each ECG marker. LAFB and QTC intervals were assessed on baseline 12-lead ECG (n=4,696). APC count was determined using 24-hour Holter recordings obtained in a random subsample (n=1,234). After adjusting for potential confounders and each ECG marker, LAFB (hazard ratio [HR. 2.1, 95% confidence interval [CI. 1.1-3.9, p=0.023), a prolonged QTC (HR 2.5, 95% CI 1.4-4.3, p=0.002), and every doubling of APC count (HR 1.2, 95% CI 1.1-1.3, p<0.001) each remained independently predictive of incident AF. The attributable risk of AF in the exposed was 35% (95% CI 13-52%) for LAFB, 25% (95% CI 0.6-44%) for a prolonged QTC , and 34% (95% CI 26-42%) for APCs. In conclusion, in a community-based cohort, 3 previously established ECG-derived AF predictors were each independently associated with incident AF, suggesting they may represent distinct mechanisms underlying the disease.