Abstract
BackgroundProlonged PR interval (PRi) is associated with adverse outcomes. However, PRi determinants are poorly known. We aimed to identify the clinical determinants of the PRi duration in the general population.HypothesisSome clinical data are associated with prolonged PRi.MethodsCross‐sectional study conducted between 2014 and 2017. Electrocardiogram‐derived PRi duration was categorized into normal or prolonged (>200 ms). Determinants were identified using stepwise logistic regression, and results were expressed as multivariable‐adjusted odds ratio (OR) (95% confidence interval). A further analysis was performed adjusting for antiarrhythmic drugs, P‐wave contribution to PRi duration, electrolytes (kalemia, calcemia, and magnesemia), and history of cardiovascular disease.ResultsOverall, 3655 participants with measurable PRi duration were included (55.6% females; mean age 62 ± 10 years), and 330 (9.0%) had prolonged PRi. Stepwise logistic regression identified male sex (OR 1.41 [1.02‐1.97]); aging (65‐74 years: OR 2.29 [1.61‐3.24], and ≥ 75 years: OR 4.21 [2.81‐6.31]); increased height (per 5 cm, OR 1.15 [1.06‐1.25]); hypertension (OR 1.37 [1.06‐1.77]); and hs troponin T (OR 1.67 [1.15‐2.43]) as significantly and positively associated, and high resting heart rate (≥70 beats/min, OR 0.43 [0.29‐0.62]) as negatively associated with prolonged PRi. After further adjustment, male sex, aging and increased height remained positively, and high resting heart rate negatively associated with prolonged PRi. Hypertension and hs troponin T were no longer associated.ConclusionIn a sample of the Swiss middle‐aged population, male sex, aging and increased height significantly increased the likelihood of a prolonged PRi duration, whereas a high resting heart rate decreased it.
Highlights
The PR interval (PRi) on the electrocardiogram (ECG) measures the conduction time from the beginning of the P-wave to the beginning of the QRS complex
After further adjustment according to model 2, male sex, older age, and increased height remained positively, and high resting heart rate negatively associated with prolonged PRi
The digital algorithm related to the PRi was incorrect for two ECGs: (a) the digital diagnosis was sinus rhythm with an extremely long PRi, while the correct manual diagnosis was atrial fibrillation (AF); (b) the digital diagnosis was an irregular rhythm with no P-wave detected, while the correct manual diagnosis was sinus rhythm
Summary
The PR interval (PRi) on the electrocardiogram (ECG) measures the conduction time from the beginning of the P-wave to the beginning of the QRS complex. History of CVD was obtained either based on patient's report (for some of the events occurring before the baseline CoLaus survey) or based on clinical data (obtained during follow-up) validated by an independent adjudication committee including cardiologists and a neurologist.[14] Participants listed their medications in the self-filled questionnaire. Model 1 tested the following covariates: sex; age (45-54, 55-64, 65-74, 75+ years); height (continuous); BMI (normal, overweight, obese); waist (normal, elevated); alcohol intake (none, moderate, excessive); smoking status (never, former, current); 10-year risk of coronary heart disease (CHD) (SCORE and AGLA: low, middle, high, very high); diabetes mellitus (yes/no); hypertension (yes/no); dyslipidemia (yes/no); renal insufficiency (yes/no); resting heart rate (
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