Abstract
Background Hypertension entails atrial remodeling that affect P-wave (PW) duration on electrocardiogram (ECG). PW indices (e.g., variance, dispersion, and terminal force) are associated with a higher risk for atrial fibrillation (AF), but their calculation requires multiple measurements of PW duration, limiting their use in clinical practice. We evaluated whether PW duration in specific ECG leads may identify patients with increased susceptibility to AF in a population of hypertensive patients. Methods In a case-control study, AF and control subjects were matched for age, sex, and left atrial (LA) dimensions. PW duration was measured from digitally stored ECGs. Logistic regression was used to assess the association of PW duration and indices with AF. Results We enrolled 44 hypertensive AF patients (16 paroxysmal and 28 persistent) and 44 hypertensive controls. AF and control subjects were matched for sex (males, n = 27), age (67 ± 8 years), LA diameter (40 ± 5 mm), and were comparable for left ventricular mass (45 ± 11 g/m2.7 vs 48 ± 12 g/m2.7, P = 0.19), ejection fraction (58 ± 7% in both groups), and prevalence of mild valvular heart disease (7% vs 5%; P = 0.64). PW duration in lead aVR was significantly higher in AF patients as compared with controls (115 ± 18 ms vs 101 ± 14 ms; P <0.0001) and was the best independent predictor of AF in multivariable logistic regression (PW ≥ 100 ms: RR = 3.7; 95% CI: 1.3-10.3; P = 0.02). Conclusions Simple measurement of PW duration in lead aVR allows effective identification of AF patients in a population of hypertensives. Confirmation of this finding in a larger population would provide a simple and effective risk marker of AF in hypertensive patients.
| Original language | English |
|---|---|
| Pages (from-to) | 167-174 |
| Number of pages | 8 |
| Journal | Annals of Noninvasive Electrocardiology |
| Volume | 20 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Mar 1 2015 |
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Keywords
- atrial fibrillation
- aVR lead
- hypertension
- P wave
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Physiology (medical)
- Medicine(all)
Cite this
P-wave duration in lead aVR and the risk of Atrial fibrillation in Hypertension. / Francia, Pietro; Ricotta, Agnese; Balla, Cristina; Adduci, Carmen; Semprini, Lorenzo; Frattari, Alessandra; Modestino, Anna; Mercanti, Federico; Sensini, Isabella; Caprinozzi, Massimo; Tocci, Giuliano; Volpe, Massimo.
In: Annals of Noninvasive Electrocardiology, Vol. 20, No. 2, 01.03.2015, p. 167-174.Research output: Contribution to journal › Article
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TY - JOUR
T1 - P-wave duration in lead aVR and the risk of Atrial fibrillation in Hypertension
AU - Francia, Pietro
AU - Ricotta, Agnese
AU - Balla, Cristina
AU - Adduci, Carmen
AU - Semprini, Lorenzo
AU - Frattari, Alessandra
AU - Modestino, Anna
AU - Mercanti, Federico
AU - Sensini, Isabella
AU - Caprinozzi, Massimo
AU - Tocci, Giuliano
AU - Volpe, Massimo
PY - 2015/3/1
Y1 - 2015/3/1
N2 - Background Hypertension entails atrial remodeling that affect P-wave (PW) duration on electrocardiogram (ECG). PW indices (e.g., variance, dispersion, and terminal force) are associated with a higher risk for atrial fibrillation (AF), but their calculation requires multiple measurements of PW duration, limiting their use in clinical practice. We evaluated whether PW duration in specific ECG leads may identify patients with increased susceptibility to AF in a population of hypertensive patients. Methods In a case-control study, AF and control subjects were matched for age, sex, and left atrial (LA) dimensions. PW duration was measured from digitally stored ECGs. Logistic regression was used to assess the association of PW duration and indices with AF. Results We enrolled 44 hypertensive AF patients (16 paroxysmal and 28 persistent) and 44 hypertensive controls. AF and control subjects were matched for sex (males, n = 27), age (67 ± 8 years), LA diameter (40 ± 5 mm), and were comparable for left ventricular mass (45 ± 11 g/m2.7 vs 48 ± 12 g/m2.7, P = 0.19), ejection fraction (58 ± 7% in both groups), and prevalence of mild valvular heart disease (7% vs 5%; P = 0.64). PW duration in lead aVR was significantly higher in AF patients as compared with controls (115 ± 18 ms vs 101 ± 14 ms; P <0.0001) and was the best independent predictor of AF in multivariable logistic regression (PW ≥ 100 ms: RR = 3.7; 95% CI: 1.3-10.3; P = 0.02). Conclusions Simple measurement of PW duration in lead aVR allows effective identification of AF patients in a population of hypertensives. Confirmation of this finding in a larger population would provide a simple and effective risk marker of AF in hypertensive patients.
AB - Background Hypertension entails atrial remodeling that affect P-wave (PW) duration on electrocardiogram (ECG). PW indices (e.g., variance, dispersion, and terminal force) are associated with a higher risk for atrial fibrillation (AF), but their calculation requires multiple measurements of PW duration, limiting their use in clinical practice. We evaluated whether PW duration in specific ECG leads may identify patients with increased susceptibility to AF in a population of hypertensive patients. Methods In a case-control study, AF and control subjects were matched for age, sex, and left atrial (LA) dimensions. PW duration was measured from digitally stored ECGs. Logistic regression was used to assess the association of PW duration and indices with AF. Results We enrolled 44 hypertensive AF patients (16 paroxysmal and 28 persistent) and 44 hypertensive controls. AF and control subjects were matched for sex (males, n = 27), age (67 ± 8 years), LA diameter (40 ± 5 mm), and were comparable for left ventricular mass (45 ± 11 g/m2.7 vs 48 ± 12 g/m2.7, P = 0.19), ejection fraction (58 ± 7% in both groups), and prevalence of mild valvular heart disease (7% vs 5%; P = 0.64). PW duration in lead aVR was significantly higher in AF patients as compared with controls (115 ± 18 ms vs 101 ± 14 ms; P <0.0001) and was the best independent predictor of AF in multivariable logistic regression (PW ≥ 100 ms: RR = 3.7; 95% CI: 1.3-10.3; P = 0.02). Conclusions Simple measurement of PW duration in lead aVR allows effective identification of AF patients in a population of hypertensives. Confirmation of this finding in a larger population would provide a simple and effective risk marker of AF in hypertensive patients.
KW - atrial fibrillation
KW - aVR lead
KW - hypertension
KW - P wave
UR - http://www.scopus.com/inward/record.url?scp=84925966156&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84925966156&partnerID=8YFLogxK
U2 - 10.1111/anec.12197
DO - 10.1111/anec.12197
M3 - Article
C2 - 25200638
AN - SCOPUS:84925966156
VL - 20
SP - 167
EP - 174
JO - Annals of Noninvasive Electrocardiology
JF - Annals of Noninvasive Electrocardiology
SN - 1082-720X
IS - 2
ER -