Interatrial block, P terminal force or fragmented QRS do not predict new-onset atrial fibrillation in patients with severe chronic kidney disease

BMC Cardiovascular Disorders

Mikko J. Järvisalo¹  Jussi Pärkkä²  Petri Kallio³  K. E. Juhani Airaksinen⁴  Tuomas Kiviniemi⁴  Niina Koivuviita⁵  Markus Hakamäki⁵  Tapio Hellman⁵  Kaj Metsärinne⁵  Roosa Lankinen⁵ 

[1] Department of Anaesthesiology and Intensive Care, Turku University Hospital and University of Turku, PO Box 52, Hämeentie 11, 20521, Turku, Finland;Perioperative Services, Intensive Care and Pain Medicine, Turku University Hospital and University of Turku, PO Box 52, Hämeentie 11, 20521, Turku, Finland;Department of Clinical Physiology, Turku University Hospital and University of Turku, PO Box 52, Hämeentie 11, 20521, Turku, Finland;Department of Clinical Physiology, Turku University Hospital and University of Turku, PO Box 52, Hämeentie 11, 20521, Turku, Finland;Paavo Nurmi Centre & Unit for Health and Physical Activity, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland;Heart Center, Turku University Hospital and University of Turku, PO Box 52, Hämeentie 11, 20521, Turku, Finland;Kidney Center, Turku University Hospital and University of Turku, PO Box 52, Hämeentie 11, 20521, Turku, Finland;

关键词: Atrial fibrillation;    Chronic kidney disease;    Left atrial enlargement;    Fragmented QRS;    Incidence;   

DOI  :  10.1186/s12872-020-01719-3

来源: Springer

【 摘 要 】

BackgroundThe prevalence of left atrial enlargement (LAE) and fragmented QRS (fQRS) diagnosed using ECG criteria in patients with severe chronic kidney disease (CKD) is unknown. Furthermore, there is limited data on predicting new-onset atrial fibrillation (AF) with LAE or fQRS in this patient group.MethodsWe enrolled 165 consecutive non-dialysis patients with CKD stage 4–5 without prior AF diagnosis between 2013 and 2017 in a prospective follow-up cohort study. LAE was defined as total P-wave duration ≥120 ms in lead II ± > 1 biphasic P-waves in leads II, III or aVF; or duration of terminal negative portion of P-wave > 40 ms or depth of terminal negative portion of P-wave > 1 mm in lead V1 from a baseline ECG, respectively. fQRS was defined as the presence of a notched R or S wave or the presence of ≥1 additional R waves (R’) or; in the presence of a wide QRS complex (> 120 ms), > 2 notches in R or S waves in two contiguous leads corresponding to a myocardial region, respectively.ResultsMean age of the patients was 59 (SD 14) years, 56/165 (33.9%) were female and the mean estimated glomerular filtration rate was 12.8 ml/min/1.73m2. Altogether 29/165 (17.6%) patients were observed with new-onset AF within median follow-up of 3 [IQR 3, range 2–6] years. At baseline, 137/165 (83.0%) and 144/165 (87.3%) patients were observed with LAE and fQRS, respectively. Furthermore, LAE and fQRS co-existed in 121/165 (73.3%) patients. Neither findings were associated with the risk of new-onset AF within follow-up.ConclusionThe prevalence of LAE and fQRS at baseline in this study on CKD stage 4–5 patients not on dialysis was very high. However, LAE or fQRS failed to predict occurrence of new-onset AF in these patients.

【 授权许可】

CC BY