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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Interatrial block and P terminal force in the general population - Longitudinal changes, risk factors and prognosis

Tiia Istolahti1, Antti Eranti2, Heini Huhtala3

  • 1Faculty of Medicine and Health Technology, Tampere University, Finnish Cardiovascular Research Center, Tampere, Finland; Department of Cardiology, Vaasa Central Hospital, Vaasa, Finland.

Journal of Electrocardiology
|May 9, 2022
PubMed

Insights

P-wave abnormalities like interatrial block (IAB) are linked to cardiovascular risk factors and atrial fibrillation (AF). These ECG changes can be reversible over time in the general population.

Area of Science:

  • Cardiology
  • Electrocardiography
  • Atrial Electrophysiology

Background:

  • Partial and advanced interatrial block (IAB) and P terminal force (PTF) are indicators of atrial remodeling and risk factors for atrial fibrillation (AF).
  • Limited data exists on the persistence and influencing factors of these P-wave abnormalities.

Purpose of the Study:

  • To investigate the risk factors associated with the development of partial and advanced IAB and PTF.
  • To determine the prognostic significance of these ECG abnormalities for incident atrial fibrillation (AF).
  • To assess the reversibility of these P-wave abnormalities in a general population cohort.

Main Methods:

  • Utilized ECG data from 6058 Finnish participants, with a subset of 3224 undergoing re-examination after 11 years.
  • Employed binomial logistic regression to identify risk factors for incident P-wave abnormalities (IAB, PTF).
  • Applied time-varying Cox regression to analyze the association between ECG changes and new-onset AF.

Main Results:

  • Reversal rates to normal were 47.4% for partial IAB, 40.0% for advanced IAB, and 79.3% for PTF.
  • Independent risk factors for P-wave abnormalities included age, male sex, hypertension, higher BMI, elevated LDL cholesterol, left ventricular hypertrophy, and use of specific cardiovascular medications.
  • Partial IAB (HR 1.28) and advanced IAB (HR 1.72) were independently associated with increased AF risk.

Conclusions:

  • Conventional cardiovascular risk factors contribute to the incidence of new P-wave abnormalities.
  • Partial and advanced IAB are significant predictors of increased atrial fibrillation risk.
  • P-wave abnormalities demonstrate a notable degree of reversibility during long-term follow-up in the general population.
Abstract

Keywords:
Atrial fibrillationECGInteratrial blockP terminal forceP wave

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