Impact of P-wave indices in prediction of atrial fibrillation-Insight from loop recorder analysis.


Journal

Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc
ISSN: 1542-474X
Titre abrégé: Ann Noninvasive Electrocardiol
Pays: United States
ID NLM: 9607443

Informations de publication

Date de publication:
Sep 2021
Historique:
revised: 17 03 2021
received: 17 02 2021
accepted: 29 03 2021
pubmed: 9 5 2021
medline: 15 12 2021
entrez: 8 5 2021
Statut: ppublish

Résumé

Several P-wave indices are associated with the development of atrial fibrillation (AF). However, previous studies have been limited in their ability to reliably diagnose episodes of AF. Implantable loop recorders allow long-term, continuous, and therefore more reliable detection of AF. The aim of this study is to identify and evaluate ECG parameters for predicting AF by analyzing patients with loop recorders. This study included 366 patients (mean age 62 ± 16 years, mean LVEF 61 ± 6%, 175 women) without AF who underwent loop recorder implantation between 2010-2020. Patients were followed up on a 3 monthly outpatient interval. During a follow-up of 627 ± 409 days, 75 patients (20%) reached the primary study end point (first detection of AF). Independent predictors of AF were as follows: age ≥68 years (hazard risk [HR], 2.66; 95% confidence interval [CI], 1.668-4.235; p < .001), P-wave amplitude in II <0.1 mV (HR, 2.11; 95% CI, 1.298-3.441; p = .003), P-wave terminal force in V Our study indicated that P-wave indices are suitable for predicting AF episodes. Furthermore, it is possible to stratify patients into risk groups for AF using simple ECG parameters, which is particularly important for patients with cryptogenic stroke.

Sections du résumé

BACKGROUND BACKGROUND
Several P-wave indices are associated with the development of atrial fibrillation (AF). However, previous studies have been limited in their ability to reliably diagnose episodes of AF. Implantable loop recorders allow long-term, continuous, and therefore more reliable detection of AF.
HYPOTHESIS OBJECTIVE
The aim of this study is to identify and evaluate ECG parameters for predicting AF by analyzing patients with loop recorders.
METHODS METHODS
This study included 366 patients (mean age 62 ± 16 years, mean LVEF 61 ± 6%, 175 women) without AF who underwent loop recorder implantation between 2010-2020. Patients were followed up on a 3 monthly outpatient interval.
RESULTS RESULTS
During a follow-up of 627 ± 409 days, 75 patients (20%) reached the primary study end point (first detection of AF). Independent predictors of AF were as follows: age ≥68 years (hazard risk [HR], 2.66; 95% confidence interval [CI], 1.668-4.235; p < .001), P-wave amplitude in II <0.1 mV (HR, 2.11; 95% CI, 1.298-3.441; p = .003), P-wave terminal force in V
CONCLUSIONS CONCLUSIONS
Our study indicated that P-wave indices are suitable for predicting AF episodes. Furthermore, it is possible to stratify patients into risk groups for AF using simple ECG parameters, which is particularly important for patients with cryptogenic stroke.

Identifiants

pubmed: 33963655
doi: 10.1111/anec.12854
pmc: PMC8411742
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e12854

Informations de copyright

© 2021 The Authors. Annals of Noninvasive Electrocardiology published by Wiley Periodicals LLC.

Références

Heart Lung Circ. 2019 Nov;28(11):1664-1669
pubmed: 30527848
Am J Cardiol. 1977 Jun;39(7):967-71
pubmed: 141202
Ann Noninvasive Electrocardiol. 2016 Jan;21(1):20-9
pubmed: 26523405
J Atr Fibrillation. 2017 Dec 31;10(4):1724
pubmed: 29487684
Ann Noninvasive Electrocardiol. 2020 Sep;25(5):e12751
pubmed: 32274894
N Engl J Med. 2014 Jun 26;370(26):2478-86
pubmed: 24963567
Eur Heart J. 2021 Feb 1;42(5):373-498
pubmed: 32860505
Heart Rhythm. 2013 Sep;10(9):1249-56
pubmed: 23608590
Stroke. 2009 Apr;40(4):1204-11
pubmed: 19213946
J Cardiovasc Electrophysiol. 2020 Jul;31(7):1719-1725
pubmed: 32510679
Neurol Sci. 2021 Sep;42(9):3707-3714
pubmed: 33443664
Stroke. 2017 Aug;48(8):2066-2072
pubmed: 28679858
Heart Rhythm. 2014 Jul;11(7):1095-101
pubmed: 24691454
Am J Cardiol. 2007 Sep 1;100(5):850-4
pubmed: 17719332
J Am Heart Assoc. 2019 Dec 17;8(24):e014553
pubmed: 31830872
Am Heart J. 2015 Jan;169(1):53-61.e1
pubmed: 25497248
JAMA. 2009 Jun 24;301(24):2571-7
pubmed: 19549974
Am J Cardiol. 2011 Mar 15;107(6):917-921.e1
pubmed: 21255761
J Am Heart Assoc. 2013 Mar 18;2(2):e000102
pubmed: 23537808
Circ Arrhythm Electrophysiol. 2013 Oct;6(5):1041-6
pubmed: 24129206
Europace. 2018 Nov 01;20(suppl_3):iii36-iii44
pubmed: 30476059
Heart Rhythm. 2015 Jan;12(1):155-62
pubmed: 25267584
Am J Cardiol. 2011 Jan;107(1):85-91
pubmed: 21146692
Lancet. 2009 Feb 28;373(9665):739-45
pubmed: 19249635
Am Heart J. 2020 Jan;219:117-127
pubmed: 31699295
Ann Noninvasive Electrocardiol. 2001 Apr;6(2):159-65
pubmed: 11333174
Heart Rhythm. 2015 Sep;12(9):1887-95
pubmed: 25916567
Europace. 2020 Aug 1;22(8):1173-1181
pubmed: 32556298
Cerebrovasc Dis. 2021;50(1):46-53
pubmed: 33311022

Auteurs

Fabienne Kreimer (F)

University Hospital St Josef Hospital, Cardiology and Rhythmology, Ruhr University, Bochum, Germany.

Assem Aweimer (A)

University Hospital Bergmannsheil, Cardiology and Angiology, Ruhr University, Bochum, Germany.

Andreas Pflaumbaum (A)

University Hospital St Josef Hospital, Cardiology and Rhythmology, Ruhr University, Bochum, Germany.

Andreas Mügge (A)

University Hospital St Josef Hospital, Cardiology and Rhythmology, Ruhr University, Bochum, Germany.
University Hospital Bergmannsheil, Cardiology and Angiology, Ruhr University, Bochum, Germany.

Michael Gotzmann (M)

University Hospital St Josef Hospital, Cardiology and Rhythmology, Ruhr University, Bochum, Germany.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH