ECG Features Associated With Adverse Cardiovascular Outcomes in Patients With Atrial Fibrillation: A Combined AFFIRM...

Area of Science:

• Cardiology
• Electrocardiography
• Clinical Research

Background:

• The prognostic value of standard 12-lead ECG parameters in patients with atrial fibrillation (AF) history remains understudied.
• Previous research has not explored the association between ECG intervals (QRS, PR, JT, QT) and adverse cardiovascular outcomes in this population.

Purpose of the Study:

• To investigate the predictive value of standard ECG parameters for adverse cardiovascular outcomes in patients with a history of atrial fibrillation (AF).
• To assess the association between QRS duration, PR interval, JT interval, and QT interval with mortality and hospitalization in AF patients.

Main Methods:

• Pooled analysis of patient-level data from 5,436 patients with a history of non-permanent AF from the AFFIRM and AF-CHF trials.
• Multivariate Cox regression models were used to assess the predictive value of ECG parameters in both AF and sinus rhythm states.
• Follow-up duration was 40.8 ± 16.3 months.

Main Results:

• Prolonged QRS duration (>120 ms) independently predicted all-cause mortality, cardiovascular mortality, and arrhythmic mortality in AF patients.
• Increased QRS duration was also associated with increased risk of any hospitalization and cardiovascular hospitalization in AF patients.
• An increased PR interval (>200 ms) was independently associated with cardiovascular and arrhythmic mortality.

Conclusions:

• Standard ECG parameters, specifically QRS duration and PR interval, are significant independent predictors of adverse cardiovascular outcomes in patients with a history of AF.
• These simple ECG findings provide valuable prognostic information for risk stratification and management in AF patients.