Abnormal Atrial Activation at Surface Electrocardiogram Examination in Born Underweight Young Adults

Recent published data demonstrated how subjects born preterm are at higher risk of developing early atrial fibrillation (AF).

The surface ECG of twenty-four adults, former preterm infants born with an extremely low birth weight (ex-ELBW; mean age at study: 23.2±3.3 years; mean gestational age: 27.8±2.3 weeks; mean birth weight: 840±120.1 grams), were compared with those of 24 healthy counterparts born at term (C). A few parameters known to be capable of predicting a predisposition to develop AF were examined: P wave duration and dispersion, P terminal force, isoelectric interval length, PR interval length, and advanced interatrial blocks.

A shorter PR interval length was found in ex-ELBW compared to C (p<0.0003) as well as longer P wave duration and dispersion, p terminal force, and isoelectric interval (p<0.0001, p<0.0001, p<0.01, and p<0.0004, respectively). Four cases of advanced interatrial block were detected in ex-ELBW, and none in C (p<0.0001). P wave duration, PR interval length, and P wave dispersion were significantly correlated with birth weight (r=0.51 p<0.01, r=0.46 p<0.02, and r=0.42 p<0.04, respectively). When excluding the possible influence of gestational age on birth weight, P wave duration and dispersion were found to be the only statistically significant determinants of abnormal atrial electrical activation (p<0.03 and p<0.04, respectively). On the contrary, when excluding the possible influence of birth weight on gestational age, only P wave duration remained statistically significant (p<0.05).

Surface ECG findings of abnormal atrial activity in ex-ELBW may explain their previously reported predisposition to developing AF.