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Circulation: Arrhythmia and Electrophysiology
This large ECG study investigated the long-term outcomes in individuals with electrocardiographic preexcitation from a primary care population. Patients with ventricular preexcitation had higher risk of atrial fibrillation and heart failure, with the highest risk for heart failure among patients with a right anteroseptal pathway. Although the overall risk of death in those with preexcitation was not increased, a difference occurred across age groups, where patients >65 years of age and with preexcitation had a higher risk of death than the rest of the primary care population.
Electrocardiographic Preexcitation and Risk of Cardiovascular Morbidity and Mortality
Results From the Copenhagen ECG Study
Morten W. Skov, MD
Peter V. Rasmussen, MD
Jonas Ghouse, MD
Steen M. Hansen, MD
Claus Graff, MSc, PhD
Morten S. Olesen, MSc, PhD
Adrian Pietersen, MD
Christian Torp-Pedersen, MD, DMSci
Stig Haunsø, MD, DMSci
Lars Køber, MD, DMSci
Jesper H. Svendsen, MD, DMSci
Anders G. Holst, MD, PhD
Jonas B. Nielsen, MD, PhD
Correspondence to: Jonas Bille Nielsen, MD, PhD, Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, 5804 Medical Science II, 1241 E. Catherine St, Ann Arbor, MI 48109-5618. E-mail firstname.lastname@example.org
BACKGROUND: The majority of available data on the clinical course of patients with ventricular preexcitation in the ECG originates from tertiary centers. We aimed to investigate long-term outcomes in individuals from a primary care population with electrocardiographic preexcitation.
METHODS AND RESULTS: Digital ECGs from 328 638 primary care patients were collected during 2001 to 2011. We identified 310 individuals with preexcitation (age range, 8–85 years). Data on medication, comorbidity, and outcomes were collected from Danish nationwide registries. The median follow-up time was 7.4 years (quartiles, 4.6–10.3 years). Compared with the remainder of the population, patients with preexcitation had higher adjusted hazards of atrial fibrillation (hazard ratio [HR], 3.12; 95% confidence interval [CI], 2.07–4.70) and heart failure (HR, 2.11; 95% CI, 1.27–3.50). Subgroup analysis on accessory pathway location revealed …