Abstract 14070: Combination of Clinical, Electrocardiographic and Echocardiographic Parameters Predict the Onset of Atrial Fibrillation
Bacground: The ability to identify risk markers for first atrial fibrillation (AF) is critical to the development of preventive strategies. Prior studies have demonstrated that advanced age, diabetes, hypertension, and cardiovascular disease increase the risk of developing AF. Echocardiographic left atrial (LA) size and diastolic dysfunction are also shown to predict the onset of AF. Furthermore, a recent study has revealed that the addition of premature atrial contraction (PAC) count to a validated AF risk algorithm provides superior AF risk discrimination. However, it remains unknown whether a combination of clinical, electrocardiographic, and echocardiographic parameters predict the onset of AF. In the present study, we evaluated the predictive value of the combined score including these parameters.
Methods: We retrospectively studied 1,040 patients without AF in whom both echocardiography and 24-hour Holter electrocardiography were performed from May 2005 to December 2010 and could be followed thereafter. During the follow-up period of 70.0±29.1 months, we investigated the new onset of AF.
Results: Of the 1,040 patients, 103 developed AF. Patients who developed AF were older than patients who did not. Total heart rate, PAC count, max RR interval, and frequency of sinus arrest quantified by 24-hour electrocardiography were associated with the new onset of AF. Left atrial diameter (LAD) determined by echocardiography was also associated with the development of AF. In multivariate Cox analyses, age, PAC count, max RR interval, and LAD were independently associated with the development of AF (multivariable-adjusted hazard ratios per SD: age 1.49, PAC count 1.16, max RR interval 1.21, and LAD 1.34). Furthermore, the predictive value of the combined score using these 4 parameters (hazard ratios per SD: 1.80) was higher than that of each parameter.
Conclusion: The combined score using age, PAC count, max RR interval, and LAD could help to identify risk of the new onset of AF.
Author Disclosures: T. Soeki: None. S. Bando: None. T. Matsuura: None. T. Tobiume: None. E. Uematsu: None. K. Kusunose: None. T. Ise: None. K. Yamaguchi: None. S. Yagi: None. D. Fukuda: None. H. Yamada: None. T. Wakatsuki: None. M. Shimabukuro: None. M. Sata: None.
- © 2015 by American Heart Association, Inc.