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Cited by 126Atrial Fibrillation Management and OutcomesCardiac electrophysiology and arrhythmiasCardiac pacing and defibrillation studies

Risk of atrial fibrillation as a function of the electrocardiographic PR interval: Results from the Copenhagen ECG Study

Nielsen, Jonas Bille, Pietersen, Adrian, Graff, Claus, Lind, Bent, Struijk, Johannes Jan, Olesen, Morten Salling, Haunsø, Stig, Gerds, Thomas Aalexander +4 more·2013·Heart Rhythm
DOI 10.1016/j.hrthm.2013.04.012
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Abstract

Background Prolongation of the PR interval has been associated with an increased risk of incident atrial fibrillation (AF).Objective To determine if there was a nonlinear relation between PR interval duration and the risk of AF.Methods We included 288,181 individuals, corresponding to one third of the population in the greater region of Copenhagen. These individuals had a digital electrocardiogram (ECG) recorded in a general practitioner's core facility from 2001 to 2010. Data on drug use, comorbidity, and outcomes were collected from Danish registries.Results During a median follow-up period of 5.7 years, 11,087 developed AF. Having a PR interval ≥95th percentile (≥196 ms for women, ≥204 ms for men) was associated with an increased risk of AF as evidenced by a multivariable-adjusted hazard ratio (HR) of 1.18 (95% confidence interval [CI] 1.06-1.30, P = .001) for women and 1.30 (1.17-1.44, P < .001) for men compared with the respective reference groups (PR interval between 40th and 60th percentile). Having a short PR interval <5th percentile (≤121 ms for women, ≤129 ms for men) was also associated with an increased risk of AF for women (HR 1.32, 95% CI 1.12-1.56, P = .001), but this was not significant for men (HR 1.09, 95% CI 0.92-1.29, P = .33).Conclusion In this large ECG study, we found an increased risk of AF for longer PR intervals for both women and men. With respect to short PR intervals, we also observed an increased risk of AF for women.

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  • The bulk of studies evaluating sex differences in the AF-related risk of heart failure have showed no significant difference; however, a few studies have suggested higher risk in women.

    “The bulk of studies evaluating sex differences in the AF-related risk of HF have showed no significant difference; however, a few studies have suggested higher risk in women (Supplementary Table S8).”

    From Atrial fibrillation in women: epidemiology, pathophysiology, presentation, and prognosis (2016) · cites this paper as [99]

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Authors
Nielsen, J. B., Pietersen, A., Graff, C., Lind, B., Struijk, J. J., Olesen, M. S., Haunsø, S., Gerds, T. A., Ellinor, P. T., Køber, L., Svendsen, J. H., & Holst, A. G.
Affiliations
  • University of Copenhagen (DK)
  • Aalborg University (DK)
  • Massachusetts General Hospital (US)
Corresponding author
Nielsen, Jonas Bille
ORCID
Venue
Heart Rhythm
Publisher
Elsevier BV
Published
2013-09
Volume
10
Issue
9
Pages
1249-1256
ISSN
1547-5271 (ISSN-L)
DOI
10.1016/j.hrthm.2013.04.012
OpenAlex
W1966470544
Cited by
126
References
33
Citations by year
2026: 8 · 2025: 4 · 2024: 7 · 2023: 14 · 2022: 10 · 2021: 12 · 2020: 13 · 2019: 10 · 2018: 9 · 2017: 11 · 2016: 10 · 2015: 8 · 2014: 7 · 2013: 3
FWCI
6.35
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Heart Rhythm (publishedVersion)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
  • VBN Forskningsportal (Aalborg Universitet) (submittedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
Keywords
atrial fibrillation, PR interval, nonlinear relationship, sex differences, incident atrial fibrillation risk
MeSH terms
Adult, Aged, Atrial Fibrillation, Denmark, Electrocardiography, Female, Heart Conduction System, Heart Rate, Humans, Male, Middle Aged, Registries, Risk Factors, Sex Factors, Urban Population

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