Association of P-Wave Axis With Incident Atrial Fibrillation in Diabetes Mellitus (from the ACCORD Trial)

Dhaliwal, Karanpreet; Upadhya, Bharathi; Soliman, Elsayed Z.; Beaty, Elijah; Yeboah, Joseph; Bhave, Prashant D.; Whalen, S. Patrick; Singleton, Matthew J.

doi:10.1016/j.amjcard.2020.05.009

Cited by 9 publications

(2 citation statements)

References 22 publications

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“…one that can be included in a risk prediction score) and where sufficient information was reported or available from the authors, yielding 22 separate articles (Figure 1). The relevant ECG patterns and the number of publications were as follows; P wave terminal force V1 (PTFV1) 5, [17][18][19][20][21] Interatrial block (IAB) 8, 17,18,20,[22][23][24][25][26][27] advanced interatrial block (aIAB) 4, 18,20,28,29 abnormal P wave axis (aPWA) 7, 17,20,27,[30][31][32][33] PR prolongation 5, 17,20,22,34,35 Atrial premature complexes (APCs) 4, [35][36][37][38] (Figure 2). The pooled number of patients was 609,496 patients (22,947 patients for PTFV1, The patient and data characteristics of each study are tabulated in Table 1.…”

Section: Resultsmentioning

confidence: 99%

Predicting risk of AF in ischaemic stroke using sinus rhythm ECG abnormalities: A meta-analysis

Berry-Noronha

Bonavia

Wilson

et al. 2023

European Stroke Journal

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Objective: To identify ECG changes in sinus rhythm that may be used to predict subsequent development of new AF. Method: We identified prospective and retrospective cohort or case control studies evaluating ECG patterns from a 12-lead ECG in sinus rhythm taken in hospital or community predicting subsequent development of new AF. For each identified ECG predictor, we then identify absolute event rates and pooled risk ratios (RR) using an aggregate level random effects meta-analysis. Results: We identified 609,496 patients from 22 studies. ECG patterns included P wave terminal force V1 (PTFV1), interatrial block (IAB) and advanced interatrial block (aIAB), abnormal P wave axis (aPWA), PR prolongation and atrial premature complexes (APCs). Pooled risk ratios reached significance for each of these; PTFV1 RR 1.48 (95% CI 1.04–2.10), IAB 2.54 (95% CI 1.64–3.93), aIAB 4.05 (95% CI 2.64–6.22), aPWA 1.89 (95% CI 1.25–2.85), PR prolongation 2.22 (95% CI 1.27–3.87) and APCs 3.71 (95% CI 2.23–6.16). Diabetes reduced the predictive value of PR prolongation. Conclusion: APC and aIAB were most predictive of AF, while IAB, PR prolongation, PTFV1 and aPWA were also significantly associated with development of AF. These support their use in a screening tool to identify at risk cohorts who may benefit from further investigation, or following stroke, with empirical anticoagulation.

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Section: Resultsmentioning

confidence: 99%

Predicting risk of AF in ischaemic stroke using sinus rhythm ECG abnormalities: A meta-analysis

Berry-Noronha

Bonavia

Wilson

et al. 2023

European Stroke Journal

View full text Add to dashboard Cite

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“…Abnormal P-wave axis (aPWA) Four studies (n=28,563) reported abnormal P-wave axis (outside 0-75 degrees) to predict AF. These included two large cohorts drawn from the community, a large cohort of patients with diabetes (n=8965) , and one cohort of patients following stroke (n=222) (15,28,(34)(35)(36). P-wave axis was not identified as a predictor of AF in one study conducted in an ESUS population.…”

Section: P-wave Dispersionmentioning

confidence: 99%