Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Sep;36(9):1401-1409.
doi: 10.1007/s00380-021-01805-2. Epub 2021 Feb 17.

First-degree atrioventricular block is significantly associated with incident atrial fibrillation in the population predominantly including participants aged ≥ 60 years

Yoshihiro Tanaka  1   2 , Hayato Tada  3 , Rikuta Hamaya  4   5   6 , Ravi B Patel  7   8 , Kenshi Hayashi  3 , Kan Yamagami  3 , Atsushi Hashiba  9 , Masayuki Takamura  3 , Masa-Aki Kawashiri  3 , Philip Greenland  7
Affiliations

First-degree atrioventricular block is significantly associated with incident atrial fibrillation in the population predominantly including participants aged ≥ 60 years

Yoshihiro Tanaka et al. Heart Vessels. 2021 Sep.

Abstract

Some previous studies demonstrated that first-degree atrioventricular block (f-AVB) was associated with incident atrial fibrillation (AF), while evidence is scarce regarding the association between f-AVB and incident AF in older populations. Therefore, we sought to investigate the association of f-AVB with incident AF in the population predominantly including participants aged ≥ 60 years. Eligible participants were residents in Kanazawa City, Japan aged ≥ 40 years who underwent 12-lead ECG at the National Japanese Health Check-up in 2013. Participants with AF detected at the baseline exam and those without adequate follow-up were excluded. f-AVB was defined as PR interval ≥ 220 ms based on the Minnesota code (6-3). The cumulative incidence of AF was estimated by the Kaplan-Meier curve analysis, and statistical significance was evaluated by the Log-rank test. Unadjusted and adjusted hazard ratios (HRs) were computed by Cox proportional hazard models. HRs were adjusted for conventional risk factors for AF. 37,730 participants (mean age, 72.3 ± 9.6 years; male, 37%) were included. Baseline f-AVB was observed in 667 (1.8%) participants. During the median follow-up period of 5 years (interquartile range, 4.0-5.0 years), 691 cases of incident AF were observed. A 5-year cumulative incidence of AF was significantly higher in f-AVB (+) group compared with f-AVB (-) group (6.8% vs 2.1%, p < 0.01). In the fully adjusted model, f-AVB was significantly associated with incident AF (HR, 1.75; 95% confidence interval 1.25-2.45; p value < 0.01). f-AVB was independently associated with incident AF in the population predominantly including participants aged ≥ 60 years.

Keywords: Atrioventricular block; Incident atrial fibrillation.

PubMed Disclaimer

Conflict of interest statement

Compliance with ethical standards

Conflict of interest The authors declare that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
STROBE flow diagram for study inclusion. Advance AVB was defined as any types of second-degree AVB and/or complete AVB based on the Minnesota code. AF atrial fibrillation, AVB atrioventricular block, ECG electrocardiogram
Fig. 2
Fig. 2
Cumulative incidence of AF by the presence or absence of first-degree atrioventricular block. During median follow-up period of 5.0 years, a total of 667 f-AVB cases were observed. Cumulative incidence of AF was significantly higher in f-AVB (+) group compared with f-AVB (−) group (6.8% vs 2.1%, p < 0.01). AF atrial fibrillation, f-AVB first-degree atrioventricular block
Fig. 3
Fig. 3
IPW-weighted Kaplan–Meier curve analysis by the presence and absence of first-degree atrioventricular block. Cumulative incidence of AF was significantly higher in f-AVB (+) group than in f-AVB (−) group (3.7% vs 2.1%, p < 0.05). AF atrial fibrillation, f-AVB first-degree atrioventricular block, IPW inverse probability of weighting
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Tanaka Y, Bundy JD, Allen NB, Uddin SMI, Feldman DI, Michos ED, Heckbert SR, Greenland P (2020) Association of erectile dysfunction with incident atrial fibrillation: the multi-ethnic study of atherosclerosis (MESA). Am J Med 133:613–620.e1 - PMC - PubMed
    1. Jurin I, Lucijanic M, Jurin H, Starcevic B, Varvodic J, Catic J, Jurisic A, Vitlov P, Tomic SS, Lucijanic J, Hadzibegovic I (2020) Patients with atrial fibrillation and mid-range ejection fraction differ in anticoagulation pattern, thrombotic and mortality risk independently of CHA. Heart Vessels 35:1243–1249 - PubMed
    1. Perlman LV, Ostrander LD, Keller JB, Chiang BN (1971) An epidemiologic study of first degree atrioventricular block in Tecumseh, Michigan. Chest 59:40–46 - PubMed
    1. Aro AL, Anttonen O, Kerola T, Junttila MJ, Tikkanen JT, Rissanen HA, Reunanen A, Huikuri HV (2014) Prognostic significance of prolonged PR interval in the general population. Eur Heart J 35:123–129 - PubMed
    1. Mymin D, Mathewson FA, Tate RB, Manfreda J (1986) The natural history of primary first-degree atrioventricular heart block. N Engl J Med 315:1183–1187 - PubMed