Electrocardiogram P-Wave Dispersion and New-Onset Atrial Fibrillation: A Nested Case-Control Study

Area of Science:

• Cardiology
• Electrophysiology
• Preventive Medicine

Background:

• Atrial fibrillation (AF) is a common arrhythmia.
• Early identification of individuals at risk for new-onset AF (NAF) is crucial for timely intervention and improved patient outcomes.
• Electrocardiogram (ECG) parameters may offer insights into AF risk.

Purpose of the Study:

• To investigate the association between P-wave dispersion (Pd) measured via ECG during sinus rhythm and the subsequent risk of developing NAF within one year.
• To identify potential biomarkers for early risk stratification of NAF.

Main Methods:

• A retrospective nested case-control study was conducted involving 824 participants (206 NAF cases, 618 controls).
• ECG, echocardiographic, laboratory, and clinical data were collected within one year of the NAF diagnosis index date.
• Conditional logistic regression models and generalized additive models (GAMs) were used to analyze the association between ECG parameters and NAF risk.

Main Results:

• Participants who developed NAF exhibited significantly higher P-wave duration, P-wave dispersion (Pd), and left atrial diameter compared to controls.
• Increased Pd was independently associated with a higher risk of NAF within one year (OR: 1.149, 95% CI: 1.099-1.202).
• Curve fitting confirmed a positive correlation between Pd and NAF risk.

Conclusions:

• ECG P-wave dispersion (Pd) during sinus rhythm is an independent predictor of new-onset atrial fibrillation (NAF) within one year.
• Measuring Pd may aid in identifying individuals at higher risk for NAF, facilitating earlier clinical management.