Short-term repeatability of electrocardiographic P wave indices and PR interval

Snyder, Michelle; Soliman, Elsayed Z.; Whitsel, Eric A.; Gellert, Kapuaola S.; Heiss, Gerardo

doi:10.1016/j.jelectrocard.2013.11.007

Cited by 25 publications

(20 citation statements)

References 28 publications

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“…This data are supported by the widespread and growing use of wearable health and fitness devices. It is estimated that 19 million people currently use wearable technology worldwide, with the market expected to increase 5‐ to 10‐fold in the next 5 years . Until the smartphone ECG was FDA approved for over‐the‐counter use on October 2, 2014, wearable health measures were limited to heart rate and activity monitors; no devices included a real‐time ECG.…”

Section: Discussionmentioning

confidence: 99%

Wireless Smartphone ECG Enables Large‐Scale Screening in Diverse Populations

Haberman

Jahn

Bose

et al. 2015

Cardiovasc electrophysiol

195

148

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Section: Discussionmentioning

confidence: 99%

Wireless Smartphone ECG Enables Large‐Scale Screening in Diverse Populations

Haberman

Jahn

Bose

et al. 2015

Cardiovasc electrophysiol

195

148

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“…First, both P-wave duration and P-wave terminal force measurements are less reproducible over time than PR interval, P-wave axis and P wave area. 37 Second, one could consider adjusting the P value for significant results for the two traits considered (5×10 −8 /2 = 2.5×10 −8 ); however, the P-wave duration and P-wave terminal force are only weakly correlated so we used a conventional threshold for genome wide significance of 5×10 −8 . Third, associations with p-values in the range of 1×10 −8 to 10 −10 will require replication in independent cohorts.…”

Section: Discussionmentioning

confidence: 99%

Fifteen Genetic Loci Associated With the Electrocardiographic P Wave

Christophersen¹,

Magnani²,

Yin³

et al. 2017

Circ Cardiovasc Genet

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Background The P-wave on an electrocardiogram is a measure of atrial electrical function and its characteristics may serve as predictors for atrial arrhythmias. Increased mean P-wave duration and P-wave terminal force traditionally have been used as markers for left atrial enlargement and both have been associated with increased risk of atrial fibrillation. Here, we explore the genetic basis of P-wave morphology through meta-analysis of genome-wide association study (GWAS) results for P-wave duration and P-wave terminal force from twelve cohort studies. Methods and Results We included 44,456 individuals, of which 6,778 (16%) were of African ancestry. Genotyping, imputation, and GWAS were performed at each study site. Summary level results were meta-analyzed centrally using inverse-variance weighting. In meta-analyses of P-wave duration, we identified six significant (P<5×10−8) novel loci, and replicated a prior association with SCN10A. We identified three loci at SCN5A, TBX5, and CAV1/CAV2 that were jointly associated with the PR-interval, PR-segment, and P-wave duration. We identified six novel loci in meta-analysis of P-wave terminal force. Four of the identified genetic loci were significantly associated with gene expression in 329 left atrial samples. Finally, we observed that some of the loci associated with the P-wave were linked to overall atrial conduction, whereas others identified distinct phases of atrial conduction. Conclusions We have identified six novel genetic loci associated with P-wave duration and six novel loci associated with P-wave terminal force. Future studies of these loci may aid in identifying new targets for drugs that may modify atrial conduction or treat atrial arrhythmias.

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“…Current ECG machines do not routinely report PTFV 1 , and its values show a moderate degree of measurement-to-measurement variation, 24 thereby limiting its immediate clinical value as a risk marker for vascular brain injury. However, these technical issues are likely to be surmountable with further clinical development of this marker, and in the meantime, PTFV 1 may serve as an important research tool in the ongoing quest to better understand cryptogenic strokes and vascular brain injury.…”

Section: Discussionmentioning

confidence: 99%

Association Between Left Atrial Abnormality on ECG and Vascular Brain Injury on MRI in the Cardiovascular Health Study

Kamel

Bartz

Longstreth

et al. 2015

Stroke

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Background and Purpose Emerging evidence suggests that atrial disease is associated with vascular brain injury in the absence of atrial fibrillation (AF). Methods The Cardiovascular Health Study prospectively enrolled community-dwelling adults ≥65 years of age. Among participants who underwent MRI, we examined associations of ECG left atrial abnormality with brain infarcts and leukoaraiosis. P-wave terminal force in lead V1 (PTFV1) was the primary measure of left atrial abnormality; P-wave area and duration were secondary predictors. We excluded participants with AF before or on their index ECG. Primary outcomes were incident infarcts and worsening leukoaraiosis from initial to follow-up scan approximately 5 years later. Secondary outcomes were prevalent infarcts and degree of leukoaraiosis on initial MRI. Relative risk and linear regression models adjusted for vascular risk factors. Results Among 3,129 participants with ≥1 scan, each SD increase in PTFV1 was associated with a 0.05-point (95% CI, 0.0003–0.10) higher baseline white matter grade on a 10-point scale. PTFV1 was associated with prevalent infarcts of any type (RR per SD, 1.09; 95% CI, 1.04–1.16), and more so with prevalent non-lacunar infarcts (RR per SD, 1.22; 95% CI, 1.08–1.38). Among 1,839 participants with 2 scans, PTFV1 was associated with worsening leukoaraiosis (RR per SD, 1.09; 95% CI, 1.01–1.18), but not incident infarcts (RR per SD, 1.06; 95% CI, 0.93–1.20). Sensitivity analyses adjusting for incident AF found similar results. P-wave area and duration were not associated with outcomes. Conclusions ECG left atrial abnormality is associated with vascular brain injury in the absence of documented AF.

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Short-term repeatability of electrocardiographic P wave indices and PR interval

Cited by 25 publications

References 28 publications

Wireless Smartphone ECG Enables Large‐Scale Screening in Diverse Populations

Wireless Smartphone ECG Enables Large‐Scale Screening in Diverse Populations

Fifteen Genetic Loci Associated With the Electrocardiographic P Wave

Association Between Left Atrial Abnormality on ECG and Vascular Brain Injury on MRI in the Cardiovascular Health Study

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