Abstract
BackgroundSeveral studies have explored the association between P wave terminal force in lead V1 (PTFV1) and risk of atrial fibrillation (AF) occurrence, but the results were controversial. This meta‐analysis aimed to examine whether abnormal PTFV1 could predict AF occurrence.MethodsWe searched PubMed, Embase, and Cochrane Library databases for articles published before August 25, 2018. Pooled odds ratios (ORs) of AF occurrence were calculated using random‐effects models to explore the significance of PTFV1.ResultsA total of 12 studies examining 51,372 participants were included, with 9 studies analyzing PTFV1 as a categorical variable and 4 studies analyzing PTFV1 as a continuous variable. As a categorical variable, abnormal PTFV1 (>0.04 mm s) was significantly associated with AF occurrence with a pooled OR of 1.39 (95% confidence interval [CI] 1.08–1.79, p = .01). Subgroup analysis found that ORs of studies in hemodialysis patients (OR = 4.89, 95% CI 2.54–9.90, p < .001) and acute ischemic stroke patients (OR = 1.60, 95% CI 1.14–2.25, p = .007) were higher than general population (OR = 1.15, 95% CI 1.03–1.29, p = .01). Studies from Europe (OR = 1.05, 95% CI 0.91–1.20, p = .51) yielded lower OR of endpoints compared with Asia (OR = 1.89, 95% CI 1.38–2.60, p < .001) and United States (OR = 1.43, 95% CI 1.19–1.72, p < .001). As a continuous variable, PTFV1 was also significantly associated with AF occurrence with a polled OR per 1 standard deviation (SD) change of 1.27 (95% CI 1.02–1.59, p = .03).ConclusionsPTFV1 was significantly associated with the risk of AF and was considered to be a good predictor of AF occurrence in population with or without cardiovascular diseases.
Highlights
P wave terminal force in lead V1 (PTFV1) was first mentioned by Morris et al in 1964 (Morris, Estes, Whalen, Thompson, & Mcintosh, 1964)
PTFV1 was significantly associated with Atrial fibrillation (AF) occurrence with a polled odds ratio (OR) per 1 standard deviation (SD) change of 1.27
When PTFV1 was analyzed as a continuous variable, meta-analysis of 4 included studies (Francia et al, 2015; Goda et al, 2017; Kamel et al, 2014; Soliman et al, 2009) showed elevated PTFV1 was significantly associated with AF occurrence with a pooled OR per 1-SD change of 1.27 (Figure 2b)
Summary
P wave terminal force in lead V1 (PTFV1) was first mentioned by Morris et al in 1964 (Morris, Estes, Whalen, Thompson, & Mcintosh, 1964). It is calculated by multiplying the P prime duration by the P prime amplitude in lead V1 of electrocardiogram (ECG). Asymptomatic AF is likely underdiagnosed (Lee & Mittal, 2018). It is necessary for identifying individuals at high risk of AF from the patients and general populations. The results of previous studies were controversial This meta-analysis aimed to summarize the relevant literatures to clarify the predictive value of abnormal PTFV1 for risk of AF occurrence
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