In:
Journal of Cardiovascular Electrophysiology, Wiley, Vol. 27, No. 4 ( 2016-04), p. 404-413
Abstract:
The association between standard parameters from a simple 12‐lead ECG (i.e., QRS duration and PR, JT, and QT intervals) and adverse cardiovascular outcomes (cardiovascular mortality, all‐cause mortality, arrhythmic mortality, and hospitalizations) in patients with a history of atrial fibrillation (AF) has not been previously studied. Methods and Results A pooled analysis of patient‐level data was conducted on 5,436 patients, age 68.2 ± 8.3 years, 34.8% female, with a history of non‐permanent AF randomized in AFFIRM and AF‐CHF trials. The predictive value of ECG parameters was assessed in AF and sinus rhythm in multivariate Cox regression models. During a follow‐up of 40.8 ± 16.3 months, QRS duration 〉 120 milliseconds was independently associated with all‐cause mortality (hazard ratio [HR] 1.46, 95% confidence interval [CI; 1.21–1.76] in AF, P 〈 0.001), cardiovascular mortality (HR 1.75, 95% CI (1.15–2.65) in sinus rhythm, P = 0.009; HR 1.56, 95% CI [1.27–1.93] in AF, P 〈 0.001), arrhythmic mortality (HR 1.90, 95% CI [1.09–3.32] in sinus, P = 0.024; HR 1.84, 95% CI [1.35–2.51] in AF, P 〈 0.001), any hospitalization (HR 1.15, 95% CI [1.02–1.29] in AF, P = 0.027), and cardiovascular hospitalization (HR 1.21, 95% CI [1.06–1.37] in AF; P = 0.004). Increased PR interval ( 〉 200 milliseconds) was independently associated with cardiovascular (HR 1.56, 95% CI [1.11–2.21], P = 0.010) and arrhythmic (HR 1.91, 95% CI [1.14–3.18] , P = 0.004) mortality. The JT and QTc intervals were not predictive of mortality. Conclusions Simple parameters from standard ECGs are significantly and independently associated with adverse cardiovascular outcomes in patients with a history of AF.
Type of Medium:
Online Resource
ISSN:
1045-3873
,
1540-8167
DOI:
10.1111/jce.2016.27.issue-4
Language:
English
Publisher:
Wiley
Publication Date:
2016
detail.hit.zdb_id:
2037519-0
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