Sex-related electrocardiographic differences in patients with different types of atrial fibrillation: Results from the SWISS-AF study.

Laureanti, Rita; Conte, Giulio; Corino, Valentina D A; Osswald, Stefan; Conen, David; Roten, Laurent; Rodondi, Nicolas; Ammann, Peter; Meyer-Zuern, Christine S; Bonati, Leo; Mainardi, Luca T; Auricchio, Angelo (2020). Sex-related electrocardiographic differences in patients with different types of atrial fibrillation: Results from the SWISS-AF study. International journal of cardiology, 307, pp. 63-70. Elsevier 10.1016/j.ijcard.2019.12.053

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BACKGROUND Sex-related electrocardiographic differences are a well-known phenomenon, but not their expression in patients with atrial fibrillation (AF). In this study we aim to assess the presence of significant sex-related differences in ECG features, with particular attention to P-wave parameters, of a large cohort of patients affected by different types of AF. METHODS A 5-min resting 16-lead ECG was evaluated for 1119 AF patients in sinus rhythm. The durations of the main ECG waves and intervals were measured for both atrial and ventricular activity. Moreover, the beat-to-beat P-wave variability was computed for lead II and for the first principal component (PC1) computed across the 16 leads. The percentage of variance explained by PC1 was computed. RESULTS Males compared to females showed significantly longer RR interval (1.02 ± 0.16 s vs 0.97 ± 0.15 s, p < .001), PQ interval (191 ± 34 ms vs 183 ± 35 ms, p = .008), QRS duration (105 ± 17 ms vs 98 ± 13 ms, p = .021), significantly lower percentage of variance explained by PC1 and P-wave variability. Males with paroxysmal AF compared to females with paroxysmal AF had significantly longer RR interval (1.01 ± 0.17 s vs 0.96 ± 0.14 s, p < .001), shorter QTc (388 ± 27 ms vs 402 ± 27 ms, p < .001), lower P-wave variability in PC1. Males with persistent AF compared to females with persistent AF had significantly shorter QTc interval (396 ± 30 ms vs 407 ± 26 ms, p = .019), longer PQ interval (194 ± 35 ms vs 182 ± 30 ms, p = .037), higher V1 terminal force (2.1 ± 1.2 mV*ms vs 1.8 ± 1 mV*ms, p = .007), lower percentage of variance explained by PC1. CONCLUSIONS AF patients present with several sex-related ECG differences. Consequently, sex should be taken into account when developing ECG algorithms identifying patients at risk for AF progression.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Roten, Laurent and Rodondi, Nicolas

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0167-5273

Publisher:

Elsevier

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Andrea Flükiger-Flückiger

Date Deposited:

11 Feb 2020 10:03

Last Modified:

03 May 2020 01:36

Publisher DOI:

10.1016/j.ijcard.2019.12.053

PubMed ID:

31959406

Uncontrolled Keywords:

Atrial fibrillation Electrocardiogram P-wave Sex Swiss-AF

BORIS DOI:

10.7892/boris.139572

URI:

https://boris.unibe.ch/id/eprint/139572

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