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Relation of Electrocardiographic Left Atrial Abnormalities to Risk of Stroke in Patients with Atrial Fibrillation
- Source :
- The American Journal of Cardiology. 122:242-247
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- The P-wave terminal force in lead V1 (PTFV1) on the 12-lead electrocardiogram (ECG) quantifies left atrial (LA) structural and electrophysiologic abnormalities. We aimed to evaluate the association between PTFV1 and cerebrovascular accident (CVA) as well as LA structure and function in patients with atrial fibrillation (AF). We conducted a cross-sectional study of 229 patients with AF (60 ± 10years, 72% men) with (n = 21) and without (n = 208) a history of CVA, who underwent preablation ECG and cardiac magnetic resonance in sinus rhythm. PTFV1 was defined as the duration (in milliseconds) of the downward deflection of the P wave in lead V1 multiplied by the absolute value of its amplitude (in microvolts) on ECG. PTFV1 is associated with LA minimum volume (Vmin) and left ventricular ejection fraction but not associated with the extent of LA fibrosis quantified by cardiac magnetic resonance late gadolinium enhancement. In addition, PTFV1 is associated with CVA independent of the CHA2DS2-VASc score and LA Vmin (odds ratio 1.23; 95% confidence interval 1.08 to 1.40; p = 0.002). Furthermore, PTFV1 has an incremental value over the CHA2DS2-VASc score as a marker of CVA (p
- Subjects :
- Male
medicine.medical_specialty
Magnetic Resonance Imaging, Cine
030204 cardiovascular system & hematology
Risk Assessment
Electrocardiography
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
Atrial Fibrillation
medicine
Humans
Sinus rhythm
Heart Atria
Prospective Studies
cardiovascular diseases
Stroke
Ejection fraction
medicine.diagnostic_test
business.industry
Incidence
Atrial fibrillation
Magnetic resonance imaging
Atrial Remodeling
Odds ratio
Middle Aged
medicine.disease
United States
Confidence interval
Cross-Sectional Studies
Cardiology
Atrial Function, Left
Female
Cardiology and Cardiovascular Medicine
business
030217 neurology & neurosurgery
Follow-Up Studies
Subjects
Details
- ISSN :
- 00029149
- Volume :
- 122
- Database :
- OpenAIRE
- Journal :
- The American Journal of Cardiology
- Accession number :
- edsair.doi.dedup.....66c2d4702ff02c01400ec1bba955cc18