Irregularity and lack of p waves in short tachycardia episodes predict atrial fibrillation and ischemic stroke
(2018) In Heart Rhythm 15(6). p.805-811- Abstract
Background: Atrial fibrillation (AF) is defined as an irregular supraventricular tachycardia (SVT) without p waves, with duration >30 seconds. Whether AF characteristics during short SVT episodes predict AF and stroke is not known. Objective: The purpose of this study was to determine whether irregularity and lack of p waves, alone or in combination, during short SVT episodes increase the risk of incident AF and ischemic stroke. Methods: The population-based Malmö Diet and Cancer study includes 24-hour ECG screening of 377 AF-free individuals (mean age 64.5 years; 43% men) who were prospectively followed for >13 years. There were 65 AF events and 25 ischemic stroke events during follow-up. Subjects with an SVT episode ≥5 beats... (More)
Background: Atrial fibrillation (AF) is defined as an irregular supraventricular tachycardia (SVT) without p waves, with duration >30 seconds. Whether AF characteristics during short SVT episodes predict AF and stroke is not known. Objective: The purpose of this study was to determine whether irregularity and lack of p waves, alone or in combination, during short SVT episodes increase the risk of incident AF and ischemic stroke. Methods: The population-based Malmö Diet and Cancer study includes 24-hour ECG screening of 377 AF-free individuals (mean age 64.5 years; 43% men) who were prospectively followed for >13 years. There were 65 AF events and 25 ischemic stroke events during follow-up. Subjects with an SVT episode ≥5 beats were identified, and the longest SVT episode was assessed for irregularity and lack of p waves. The association between SVT classification and AF and stroke was assessed using multivariable adjusted Cox regression. Results: The incidence of AF increased with increasing abnormality of the SVTs. The risk-factor adjusted hazard ratio for AF was 4.95 (95% confidence interval 2.06–11.9; P <.0001) for those with short irregular SVTs (<70 beats) without p waves. The incidence of ischemic stroke was highest in the group with regular SVT episodes without p waves (hazard ratio 14.2; 95% confidence interval 3.76–57.6; P <.0001, adjusted for age and sex). Conclusion: Characteristics of short SVT episodes detected at 24-hour ECG screening are associated with incident AF and ischemic stroke. Short irregular SVTs without p waves likely represent early stages of AF or atrial myopathy. Twenty-four–hour ECG could identify subjects suitable for primary prevention efforts.
(Less)
- author
- Johnson, Linda S.B. LU ; Persson, Anders P. LU ; Wollmer, Per LU ; Juul-Möller, Steen LU ; Juhlin, Tord LU and Engström, Gunnar LU
- organization
- publishing date
- 2018-06-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Atrial fibrillation, Epidemiology, p Wave, Risk factor, Stroke, Supraventricular tachycardia
- in
- Heart Rhythm
- volume
- 15
- issue
- 6
- pages
- 7 pages
- publisher
- Elsevier
- external identifiers
-
- scopus:85047155708
- pmid:29448015
- ISSN
- 1547-5271
- DOI
- 10.1016/j.hrthm.2018.02.011
- language
- English
- LU publication?
- yes
- id
- 7eea5db4-9da8-41f4-98d3-92c21ef3c310
- date added to LUP
- 2019-05-17 15:26:57
- date last changed
- 2024-08-21 17:57:05
@article{7eea5db4-9da8-41f4-98d3-92c21ef3c310, abstract = {{<p>Background: Atrial fibrillation (AF) is defined as an irregular supraventricular tachycardia (SVT) without p waves, with duration >30 seconds. Whether AF characteristics during short SVT episodes predict AF and stroke is not known. Objective: The purpose of this study was to determine whether irregularity and lack of p waves, alone or in combination, during short SVT episodes increase the risk of incident AF and ischemic stroke. Methods: The population-based Malmö Diet and Cancer study includes 24-hour ECG screening of 377 AF-free individuals (mean age 64.5 years; 43% men) who were prospectively followed for >13 years. There were 65 AF events and 25 ischemic stroke events during follow-up. Subjects with an SVT episode ≥5 beats were identified, and the longest SVT episode was assessed for irregularity and lack of p waves. The association between SVT classification and AF and stroke was assessed using multivariable adjusted Cox regression. Results: The incidence of AF increased with increasing abnormality of the SVTs. The risk-factor adjusted hazard ratio for AF was 4.95 (95% confidence interval 2.06–11.9; P <.0001) for those with short irregular SVTs (<70 beats) without p waves. The incidence of ischemic stroke was highest in the group with regular SVT episodes without p waves (hazard ratio 14.2; 95% confidence interval 3.76–57.6; P <.0001, adjusted for age and sex). Conclusion: Characteristics of short SVT episodes detected at 24-hour ECG screening are associated with incident AF and ischemic stroke. Short irregular SVTs without p waves likely represent early stages of AF or atrial myopathy. Twenty-four–hour ECG could identify subjects suitable for primary prevention efforts.</p>}}, author = {{Johnson, Linda S.B. and Persson, Anders P. and Wollmer, Per and Juul-Möller, Steen and Juhlin, Tord and Engström, Gunnar}}, issn = {{1547-5271}}, keywords = {{Atrial fibrillation; Epidemiology; p Wave; Risk factor; Stroke; Supraventricular tachycardia}}, language = {{eng}}, month = {{06}}, number = {{6}}, pages = {{805--811}}, publisher = {{Elsevier}}, series = {{Heart Rhythm}}, title = {{Irregularity and lack of p waves in short tachycardia episodes predict atrial fibrillation and ischemic stroke}}, url = {{http://dx.doi.org/10.1016/j.hrthm.2018.02.011}}, doi = {{10.1016/j.hrthm.2018.02.011}}, volume = {{15}}, year = {{2018}}, }