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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
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Electrocardiographic left atrial abnormalities predict cardiovascular mortality.

Le Dung Ha1, Aaron F Grober2, Julia Hock3

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|July 13, 2018
PubMed
Summary

Specific P-wave patterns on electrocardiograms, particularly a negative deflection ≤-100 μV or a duration ≥140 ms, are significantly associated with cardiovascular death (CVD). These findings offer valuable insights for risk stratification in clinical practice.

Keywords:
ElectrocardiogramP wavesPrognosis

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Area of Science:

  • Cardiology
  • Medical Diagnostics
  • Public Health

Background:

  • Electrocardiography (ECG) is crucial for diagnosing left atrial abnormalities.
  • Current ECG criteria for P-wave abnormalities are variable and lack a definitive imaging gold standard.
  • Understanding P-wave morphology associations with cardiovascular outcomes is essential for improved risk assessment.

Purpose of the Study:

  • To determine the prevalence of different P-wave patterns on ECGs.
  • To identify specific P-wave components associated with cardiovascular death (CVD).
  • To enhance the diagnostic utility of ECG in predicting adverse cardiac events.

Main Methods:

  • Retrospective analysis of 20,827 veterans undergoing ECGs between 1987 and 1999.
  • Median follow-up duration of 17.8 years for CVD.
  • Statistical analyses included ROC, Kaplan-Meier, and Cox Hazard models, adjusted for covariates.

Main Results:

  • A negative P-wave deflection in V1 or V2 ≤-100 μV was significantly associated with CVD (adjusted HRs 2.9-4.1).
  • Total P-wave duration ≥140 ms was independently associated with CVD (adjusted HR 2.2).
  • These ECG findings demonstrated a strong correlation with increased risk of cardiovascular death.

Conclusions:

  • Specific P-wave characteristics, including negative amplitude and prolonged duration, are independent predictors of CVD.
  • These ECG findings provide valuable, quantifiable markers for cardiovascular risk stratification.
  • The study highlights the potential for refining ECG interpretation to improve patient outcomes.