P‐wave durations from automated electrocardiogram analysis to predict atrial fibrillation and mortality in heart failure

Abstract

Background P-wave indices have been used to predict incident atrial fibrillation (AF), stroke, and mortality. However, such indices derived from automated ECG measurements have not been explored for their predictive values in heart failure (HF). We investigated whether automated P-wave indices can predict adverse outcomes in HF. Methods This study included consecutive Chinese patients admitted to a single tertiary centre, presenting with HF but without prior AF, and with at least one baseline ECG, between 1 January 2010 and 31 December 2016, with last follow-up of 31 December 2019. Results A total of 2718 patients were included [median age: 77.4, interquartile range (IQR): (66.9-84.3) years; 47.9 males]. After a median follow-up of 4.8 years (IQR: 1.9-9.0 years), 1150 patients developed AF (8.8/year), 339 developed stroke (2.6/ year), 563 developed cardiovascular mortality (4.3/year), and 1972 had all-cause mortality (15.1/year). Compared with 101-120 ms as a reference, maximum P-wave durations predicted new-onset AF at ≤90 ms [

Subclinical variations on ECG and their associations with structural brain aging networks

“…Although less is known about the correlates of abnormally short PWD, in certain instances, short PWD may be considered an earlier and more subtle feature than prolonged PWD. It has been hypothesized that shortened atrial repolarization and refractory periods could indicate changes in atrial electrical properties preceding more overt abnormalities associated with prolonged PWD, which can eventually result in arrhythmogenesis (Nielsen et al 2015, Zhou et al 2023). Recent research has started to underscore that shorter PWD is also associated with adverse outcomes, including AF, heart failure, stroke, and dementia (Ostrowska et al 2022, Ostrowska et al 2022, Chen et al 2022, Zhou et al 2023).…”