Analysis of the Association Between Electrocardiographic P-wave Characteristics and Atrial Fibrillation in the REGICOR Study

• Published in: Revista española de cardiología (English ed.) 2017-10, Vol.70 (10), p.841-847
• Main Authors: Massó-van Roessel, Albert, Escobar-Robledo, Luis Alberto, Dégano, Irene R, Grau, María, Sala, Joan, Ramos, Rafel, Marrugat, Jaume, Bayés de Luna, Antoni, Elosua, Roberto
• Format: Article
• Language: English
• Subjects: Adult; Aged; Atrial Fibrillation - epidemiology; Atrial Fibrillation - physiopathology; Cardiovascular; Case-Control Studies; Electrocardiography; Female; Heart Atria - physiopathology; Humans; Interatrial Block - epidemiology; Interatrial Block - physiopathology; Internal Medicine; Male; Middle Aged; Odds Ratio
• ISSN: 1885-5857; 1885-5857
• DOI: 10.1016/j.rec.2017.02.019

Abstract Introduction and objectives Atrial fibrillation (AF) is the most common clinically significant cardiac arrhythmia. P-wave duration and interatrial blocks (IAB) have been reported to be associated with AF. Our aim was to determine the individual and combined association of P-wave duration and advanced IAB morphology with AF. Methods We designed an age-, sex-, and survey-matched case-control study nested in a population-based cohort (REGICOR: REgistre GIroní del COR ). Two different surveys recruited a total of 9380 participants from 1999 to 2005; all participants were invited to a second examination between 2009 and 2013. For the present study, we selected participants aged 25 to 79 years with follow-up through the end of the study. All electrocardiograms were analyzed by 2 observers to determine P-wave duration and morphology (normal, partial, or advanced IAB). Results The median follow-up was 7.12 years. Eighty participants presented with AF, had a legible baseline electrocardiogram, and were included in the study, along with 160 controls. P-wave duration and the presence of partial or advanced IAB were associated with AF. When P-wave duration and morphology were considered together, only P-wave duration (≥ 110 milliseconds) showed an independent and strong association with AF. The odds ratio for AF of P-wave duration between 110-119, 120-129 and ≥ 130 milliseconds vs < 110 milliseconds were 5.33; 95%CI, 1.74-16.33, 5.08; 95%CI, 1.73-14.90 and 5.44; 95%CI, 1.95-15.15, respectively. Conclusions A P-wave longer than 110 milliseconds increases the risk of AF. Advanced IAB morphology did not seem to provide an additional AF risk beyond that of P-wave duration.