Τίτλος:
Interatrial conduction time and incident atrial fibrillation: A
prospective cohort study
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
BACKGROUND Atrial electrical conduction properties have been implicated
in atrial fibrillation (AF) pathogenesis.
OBJECTIVE The purpose of this study was to prospectively assess the
potential association of interatrial conduction time (IACT) with
incident AF.
METHODS The study included persons referred for invasive
electrophysiologic study (EPS), aged >= 50 years, without AF history or
valvular disease. IACT was defined as the interval between the high
right atrium electrogram and the distal coronary sinus atrial
electrogram.
RESULTS Six hundred twelve subjects were included (median follow-up 43
months, interquartile range 40-47). AF incidence was 21.7 cases per 1000
person-years. IACT was a significant predictor of AF with a c-statistic
of 0.770 (95% confidence interval 0.702-0.838). In time-dependent
analysis, IACT was a significant stratifier of AF risk (log-rank 28.0, P
< .001). The corresponding incidences of AF in each tertile of IACT were
3, 17, and 46 per 1000 person-years, respectively (all differences
between tertiles were significant). IACT remained significant in
multivariable Cox regression analysis, after adjustment for age, sex,
hypertension, and left atrial diameter, with each millisecond of
prolonged IACT corresponding to 7% (95% confidence interval 2%-12%)
higher adjusted risk of incident AF.
CONCLUSION IACT is independently associated with incident AF. The
invasive nature of the measurement is a limitation for its use as a
clinical risk stratifier (although it could be used in patients referred
for EPS), but these results are of interest in themselves because they
suggest a strong pathophysiologic connection between atrial conduction
times and substrate alterations ultimately leading to AF.
Συγγραφείς:
Deftereos, Spyridon
Kossyvakis, Charalampos
Efremidis, Michael
and Bouras, Georgios
Panagopoulou, Vasiliki
Papadimitriou,
Charalampos
Doudoumis, Konstantinos
Deftereos, Gerasimos and
Synetos, Andreas
Davlouros, Periklis
Toutouzas, Konstantinos and
Alexopoulos, Dimitrios
Manolis, Antonis S.
Giannopoulos,
Georgios
Εκδότης:
EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
Λέξεις-κλειδιά:
Interatrial conduction time; Electrophysiologic study;
Electrophysiologic test; P wave; P dispersion; P duration; Incidence
DOI:
10.1016/j.hrthm.2014.03.053
