P-Wave Indices: Derivation of Reference Values from the Framingham Heart Study

P wave indices constitute an intermediate, phenotype reflecting the impact of ischemic, metabolic and inflammatory insults on atrial electrophysiology and morphology. Measured from the surface electrocardiogram (ECG), they reflect dimensions of atrial depolarization and are modified by conditions that alter atrial conduction, atrial refractoriness, or may result in a proarrhythmic substrate. The P wave indices of duration and dispersion have most commonly been measured. An array of studies have utilized these P wave indices to distinguish subjects with diverse cardiovascular and non-cardiovascular conditions and diseases from healthy reference groups.(1) Computerized software has more recen…

Validation of an atrial fibrillation risk algorithm in whites and African Americans.

Background We sought to validate a recently published risk algorithm for incident atrial fibrillation (AF) in independent cohorts and other racial groups. Methods We evaluated the performance of a Framingham Heart Study (FHS)-derived risk algorithm modified for 5-year incidence of AF in the FHS (n = 4764 participants) and 2 geographically and racially diverse cohorts in the age range 45 to 95 years: AGES (the Age, Gene/Environment Susceptibility-Reykjavik Study) (n = 4238) and CHS (the Cardiovascular Health Study) (n = 5410, of whom 874 [16.2%] were African Americans). The risk algorithm included age, sex, body mass index, systolic blood pressure, electrocardiographic PR interval, hypertens…

Predicting atrial fibrillation – Authors' reply

Development of a Risk Score for Atrial Fibrillation in the Community; The Framingham Heart Study

Atrial fibrillation contributes to substantial increases in morbidity and mortality. We aimed to develop a risk score to predict individuals' absolute risk of developing the condition, and to provide a framework for researchers to assess new risk markers.We assessed 4764 participants in the Framingham Heart Study from 8044 examinations (55% women, 45-95 years of age) undertaken between June, 1968, and September, 1987. Thereafter, participants were monitored for the first event of atrial fibrillation for a maximum of 10 years. Multivariable Cox regression identified clinical risk factors associated with development of atrial fibrillation in 10 years. Secondary analyses incorporated routine e…

P wave duration and risk of longitudinal atrial fibrillation in persons ≥ 60 years old (from the Framingham Heart Study).

Long-term risk prediction is a priority for the prevention of atrial fibrillation (AF). P wave indices are electrocardiographic measurements describing atrial conduction. The role of P wave indices in the prospective determination of AF and mortality risk has had limited assessment. We quantified by digital caliper the P wave indices of maximum duration and dispersion in 1,550 Framingham Heart Study participants ≥ 60 years old (58% women) from single-channel electrocardiograms recorded from 1968 through 1971. We examined the association of selected P wave indices and long-term outcomes using Cox proportional hazards regression incorporating age, gender, body mass index, systolic blood press…