Abstract
Introduction: P-wave indices, such as prolonged p-wave duration and abnormal p-wave terminal force in V1, have been associated with incident AF. Hypothesis: We hypothesized that abnormal p-wave axis (aPWA) is associated with AF independent of traditional cardiovascular risk factors and tested our hypothesis in the ARIC study, a community-based prospective cohort study. Methods: We included in 15,319 participants without prevalent AF (age, 54.2 ± 5.7 yrs, 55.2% women, 26.5% blacks) who attended the baseline exam (1987-89). We defined aPWA as any value outside 0-75 degrees using 12-lead ECGs obtained during the baseline exam. Incident AF was identified by hospital discharge records, death certificates, and ECGs obtained during the study examinations. We used Cox proportional hazard models to estimate the hazard ratios and 95% confidence intervals of aPWA for AF. Results: During a mean follow-up of 19.8 years (1987-2012), there were 2377 incident AF cases. aPWA was independently associated with a 1.41-fold (95% CI, 1.22-1.62) increased risk of AF in the multivariable model (Table). Conclusions: aPWA is independently associated with incident AF in the general population. Further research is warranted to evaluate the ability of this readily available ECG measure in improving risk prediction of AF.
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