Amplified P-wave duration predicts incident atrial fibrillation in the general population – Results from the Hamburg City Health Study

Figures

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  Figure 1. Participant flowchart. Subjects from the Hamburg City Health Study were included in the analysis based on the outlined criteria. AF = atrial fibrillation.

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  Figure 2. Illustration of amplified PWD measurement. Digital 12-lead electrocardiogram recordings were automatically signal-averaged and displayed using amplified scaling (gain 80 mm/mV; sweep speed 175 mm/s). A: An example of a short amplified PWD (102 ms). B: A prolonged amplified PWD (142 ms). Vertical lines of the red-shaded area indicate the earliest onset and the latest offset of the amplified PWD across all leads used for measurement. PWD = P-wave duration.

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  Figure 3. Frequency distribution of amplified PWD and incidence of atrial fibrillation stratified by PWD. Left: The frequency distribution of amplified PWD for participants with (red) and without (turquoise) an end point event. Participant count was normalized to the respective maximum frequency. Right: Kaplan-Meier event curves for the primary end point with participants split into 3 bins based on their amplified PWD. Results are displayed in blue, green, and red for participants with the shortest, intermediate, and longest amplified PWD. Per bin, amplified PWD range and mean are displayed; the table displays the count of participants at risk of the end point, with percentages given in brackets. AF = atrial fibrillation; Indiv = individuals; m = mean; PWD = P-wave duration; Tert = tertile; w/o = without.

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  Figure 4. Hazard ratio for incident atrial fibrillation according to PWD. A: The hazard ratio of the amplified PWD relative to a baseline hazard for the mean of 124 ms in the study population. B: The hazard ratio of the automated PWD relative to a baseline hazard for the mean of 116 ms in the study population. m = mean; PWD = P-wave duration.