Abstract 20738: Atrial Voltage Dispersion Does Indeed Predict Atrial Fibrillation in Ischemic Stroke Patients as Well as in Controls
Introduction: Paroxysmal atrial fibrillation (AF) may be underdiagnosed in ischemic stroke patients. Given the need for anticoagulation in these patients, missing this may place them at risk for further events. We assessed ECG predictors of new-onset AF during 10-year follow-up (FU) in ischemic stroke patients.
Hypothesis: We predict a novel marker of 3-dimensional voltage magnitude per time (p-wave voltage magnitude per time, Pvm/T) will identify those at risk for AF.
Methods: The study sample comprised of 227 first-ever ischemic stroke patients without AF (median age 73, interquartile range 63-80years, 92 female) and 1:1 age- and gender-matched controls without stroke and AF enrolled in the Lund Stroke Registry from March 2001 to February 2002. New onset AF during FU was assessed by screening through regional ECG database and by record linkage with Swedish National Patient Registry. The standard 12-lead sinus rhythm ECGs at stroke admission were retrieved from electronic database and digitally processed. Clinical baseline characteristics were studied. Pvm/T (mV/ms) was assessed as a measure of depolarization dispersion. It is calculated as follows: SQRT(PV6^2 + PII^2 + (-0.5*PV2)^2) / PRd.
Results: During FU, AF was found in 39 stroke patients and 30 controls, p=0.296. In stroke patients multivariate (including age,and presence of hypertension or diabetes), Cox regression analysis AF was associated with increased dispersion of p-wave depolarization with a HR of 2.00 (95% CI 95% 1.66 to 2.40, p<0.001). New onset AF was not significantly associated with PR duration (HR 1.00 95% CI 0.99 to 1.01, P=0.966) or with P-wave duration (HR 1.02 95% CI 0.96 to 1.05, P=0.105), or with baseline ischemic stroke.
Conclusion: Increased dispersion of atrial depolarization as measured by the p-wave vector magnitude divided by the PR duration, but not baseline ischemic stroke, predict new onset AF in follow-up.
Author Disclosures: D. Cortez: None. M. Baturova: None. A. Lindgren: None. J. Carlson: None. P. Platonov: None.
- © 2016 by American Heart Association, Inc.