BACKGROUND: This study investigated 12-lead electrocardiogram (ECG) predictors associated with atrial fibrillation (AF) or flutter (AFL), specifically whether ventricular repolarization abnormalities in surface ECG (i.e., non-specific ST-T abnormalities [NSSTTA], QT prolongation, early repolarization [ER]) were associated with the development of AF or AFL.Methods and Results: This study included 16,793 ambulatory Koreans (mean age 48.2 years, 62.3% male) who underwent medical check-ups at Asan Medical Center in 2002 (NSSTTA, n=1,037 [6.2%]; ER, n=1,493 [8.9%]). The primary outcome was the incidence of ECG-documented AF or AFL. During follow-up, new-onset AF or AFL was documented in 334 subjects (2.0%). The incidence of AF or AFL at the 10-year follow-up was higher in patients with than without NSSTTA (3.5% vs. 1.6%; hazard ratio [HR] 1.79, 95% confidence interval [CI] 1.28-2.50). The QT interval was associated with a higher risk of AF or AFL (HR 1.12 [95% CI 1.07-1.17] per 10 ms), and the risk was even higher in patients with multiple-region NSSTTA (HR 2.30; 95% CI 1.64-3.21) and NSSTTA with QT prolongation (HR 4.06; 95% CI 2.14-7.69). ER was not associated with a higher risk of AF or AFL (HR 1.02; 95% CI 0.71-1.46). CONCLUSIONS: NSSTTA and QT prolongation, but not ER, were associated with a higher risk of future AF or AFL in a general ambulatory population after adjusting for parameters of atrial depolarization.
BACKGROUND: This study investigated 12-lead electrocardiogram (ECG) predictors associated with atrial fibrillation (AF) or flutter (AFL), specifically whether ventricular repolarization abnormalities in surface ECG (i.e., non-specific ST-T abnormalities [NSSTTA], QT prolongation, early repolarization [ER]) were associated with the development of AF or AFL.Methods and Results: This study included 16,793 ambulatory Koreans (mean age 48.2 years, 62.3% male) who underwent medical check-ups at Asan Medical Center in 2002 (NSSTTA, n=1,037 [6.2%]; ER, n=1,493 [8.9%]). The primary outcome was the incidence of ECG-documented AF or AFL. During follow-up, new-onset AF or AFL was documented in 334 subjects (2.0%). The incidence of AF or AFL at the 10-year follow-up was higher in patients with than without NSSTTA (3.5% vs. 1.6%; hazard ratio [HR] 1.79, 95% confidence interval [CI] 1.28-2.50). The QT interval was associated with a higher risk of AF or AFL (HR 1.12 [95% CI 1.07-1.17] per 10 ms), and the risk was even higher in patients with multiple-region NSSTTA (HR 2.30; 95% CI 1.64-3.21) and NSSTTA with QT prolongation (HR 4.06; 95% CI 2.14-7.69). ER was not associated with a higher risk of AF or AFL (HR 1.02; 95% CI 0.71-1.46). CONCLUSIONS: NSSTTA and QT prolongation, but not ER, were associated with a higher risk of future AF or AFL in a general ambulatory population after adjusting for parameters of atrial depolarization.
Entities:
Keywords:
Atrial fibrillation; Early repolarization; General population; ST segment; T wave
Authors: William J Young; Najim Lahrouchi; Aaron Isaacs; ThuyVy Duong; Luisa Foco; Farah Ahmed; Jennifer A Brody; Reem Salman; Raymond Noordam; Jan-Walter Benjamins; Jeffrey Haessler; Leo-Pekka Lyytikäinen; Linda Repetto; Maria Pina Concas; Marten E van den Berg; Stefan Weiss; Antoine R Baldassari; Traci M Bartz; James P Cook; Daniel S Evans; Rebecca Freudling; Oliver Hines; Jonas L Isaksen; Honghuang Lin; Hao Mei; Arden Moscati; Martina Müller-Nurasyid; Casia Nursyifa; Yong Qian; Anne Richmond; Carolina Roselli; Kathleen A Ryan; Eduardo Tarazona-Santos; Sébastien Thériault; Stefan van Duijvenboden; Helen R Warren; Jie Yao; Dania Raza; Stefanie Aeschbacher; Gustav Ahlberg; Alvaro Alonso; Laura Andreasen; Joshua C Bis; Eric Boerwinkle; Archie Campbell; Eulalia Catamo; Massimiliano Cocca; Michael J Cutler; Dawood Darbar; Alessandro De Grandi; Antonio De Luca; Jun Ding; Christina Ellervik; Patrick T Ellinor; Stephan B Felix; Philippe Froguel; Christian Fuchsberger; Martin Gögele; Claus Graff; Mariaelisa Graff; Xiuqing Guo; Torben Hansen; Susan R Heckbert; Paul L Huang; Heikki V Huikuri; Nina Hutri-Kähönen; M Arfan Ikram; Rebecca D Jackson; Juhani Junttila; Maryam Kavousi; Jan A Kors; Thiago P Leal; Rozenn N Lemaitre; Henry J Lin; Lars Lind; Allan Linneberg; Simin Liu; Peter W MacFarlane; Massimo Mangino; Thomas Meitinger; Massimo Mezzavilla; Pashupati P Mishra; Rebecca N Mitchell; Nina Mononen; May E Montasser; Alanna C Morrison; Matthias Nauck; Victor Nauffal; Pau Navarro; Kjell Nikus; Guillaume Pare; Kristen K Patton; Giulia Pelliccione; Alan Pittman; David J Porteous; Peter P Pramstaller; Michael H Preuss; Olli T Raitakari; Alexander P Reiner; Antonio Luiz P Ribeiro; Kenneth M Rice; Lorenz Risch; David Schlessinger; Ulrich Schotten; Claudia Schurmann; Xia Shen; M Benjamin Shoemaker; Gianfranco Sinagra; Moritz F Sinner; Elsayed Z Soliman; Monika Stoll; Konstantin Strauch; Kirill Tarasov; Kent D Taylor; Andrew Tinker; Stella Trompet; André Uitterlinden; Uwe Völker; Henry Völzke; Melanie Waldenberger; Lu-Chen Weng; Eric A Whitsel; James G Wilson; Christy L Avery; David Conen; Adolfo Correa; Francesco Cucca; Marcus Dörr; Sina A Gharib; Giorgia Girotto; Niels Grarup; Caroline Hayward; Yalda Jamshidi; Marjo-Riitta Järvelin; J Wouter Jukema; Stefan Kääb; Mika Kähönen; Jørgen K Kanters; Charles Kooperberg; Terho Lehtimäki; Maria Fernanda Lima-Costa; Yongmei Liu; Ruth J F Loos; Steven A Lubitz; Dennis O Mook-Kanamori; Andrew P Morris; Jeffrey R O'Connell; Morten Salling Olesen; Michele Orini; Sandosh Padmanabhan; Cristian Pattaro; Annette Peters; Bruce M Psaty; Jerome I Rotter; Bruno Stricker; Pim van der Harst; Cornelia M van Duijn; Niek Verweij; James F Wilson; Dan E Arking; Julia Ramirez; Pier D Lambiase; Nona Sotoodehnia; Borbala Mifsud; Christopher Newton-Cheh; Patricia B Munroe Journal: Nat Commun Date: 2022-09-01 Impact factor: 17.694