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. 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.

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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
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