Abstract 12973: PR-Interval Components and Atrial Fibrillation Risk: The Atherosclerosis Risk In Communities Study
Introduction: Reports on the association between the PR-interval and atrial fibrillation (AF) are conflicting. We hypothesized that inconsistencies stem from that fact that the PR-interval is not a single electrocardiographic (ECG) phenotype and it is more likely to represent a composite of several distinct components.
Methods: We examined the association of the PR-interval and its components (P-wave onset to P-wave peak duration, P-wave peak to P-wave end duration, and PR-segment) with AF in 14,924 participants (mean age=54±5.8 years; 26% black; 55% female) from the Atherosclerosis Risk in Communities study. The PR-interval and its components were automatically measured at baseline (1987-1989) from standard 12-lead ECGs. PR-interval >200 ms was considered prolonged and values >95th percentile defined abnormal PR-interval components. AF was ascertained during follow-up through December 31, 2010.
Results: Over a median follow-up of 21.2 years, 1,985 (13%) participants developed AF. Prolonged PR-interval was associated with an increased risk of AF (HR=1.19, 95% CI=1.02, 1.40). However, PR-interval components showed varying levels of associations with AF (P-wave onset to P-wave peak duration: HR=1.57, 95%CI=1.31, 1.88; P-wave peak to P-wave end duration: HR=1.20, 95%CI=0.99, 1.46; and PR-segment: HR=1.05, 95%CI=0.85, 1.29). Additionally, the components of the PR-interval had weak to moderate correlation with each other (correlation r ranged from -0.44 to 0.06).
Conclusions: Our findings suggest the PR-interval represents a composite of distinct components that are not uniformly associated with AF. Without considering the contribution of each component, inconsistent associations between the PR-interval and AF are inevitable.
Author Disclosures: W.T. O’Neal: None. J.W. Smith: None. M.B. Shoemaker: None. L.Y. Chen: None. A. Alonso: None. S.P. Whalen: None. E.Z. Soliman: None.
- © 2016 by American Heart Association, Inc.