Abstract 13861: Deep Terminal Negativity of P wave in V1 is Associated With Twice Higher Mortality in the Hospital Population
Introduction: Easily recognizable ECG sign deep terminal negativity of P wave in V1 (DTNPV1) represents an epiphenomenon of a fibrotic heart, and predicts sudden cardiac death in the general population.
Hypothesis: We hypothesized that DTNPV1 is associated with increased mortality in the population comprised from an entire health system ECG database.
Methods: We conducted retrospective double-cohort study and screened all 12-lead ECGs over 4 years (2010-2014) at a large hospital system and reviewed medical records to collect baseline clinical characteristics. ECGs from 130,284 individual patients were automatically analyzed in the MUSE ECG database. Children < 18 y were excluded. Two cohorts with different exposures (P-prime in V1), matched by age and sex, were comprised. The DTNPV1 cohort included participants with biphasic P wave in V1 with the amplitude of the terminal negative phase >100 μV. The zero P-prime in V1 cohort was comprised of participants with absent negative terminal deflection of P wave in V1. All-cause mortality served as a primary outcome.
Results: Each cohort consisted of 3,435 patients (mean age 58.0±16.2y; 44.8% female). In DTNPV1 cohort mean P prime in V1 amplitude was -119.4±19.6 μV. Over a mean follow-up time of 2.5 years, 7.6% patients in the zero P-prime V1 cohort and 14.3% patients in the DTNPV1 cohort had died (Figure). In Cox regression analysis, DTNPV1 was associated with a two-fold increase in risk of mortality after adjustment for age, sex, coronary artery disease, history of myocardial infarction, chronic obstructive lung disease, diabetes, liver disease, ventricular tachycardia, and atrial fibrillation/flutter [HR 1.94 (1.65-2.28); P<0.001].
Conclusions: DTNPV1 in a population from an entire health system ECG database is independently associated with twice higher risk of all-cause death, as compared to patients without negative deflection of P prime in V1.
Author Disclosures: L.G. Tereshchenko: Research Grant; Significant; Boston Scientific, Medtronic, Inc. L. Hawkins: None. T. Feldman: None. J. Sklenar: None. C. Henrikson: Research Grant; Modest; Biosense Webster. Other; Significant; Boston Scientific, St Jude Medical, Medtronic.
- © 2015 by American Heart Association, Inc.