Cardiology Medical News about first-degree atrioventricular block;long-termoutcome;prolonged PR interval

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Long-term outcomes in individuals with prolonged PR interval or first-degree atrioventricular block
JAMA, 06/25/09

Cheng S et al. – Prolongation of the PR interval is associated with increased risks of atrial fibrillation (AF), pacemaker implantation, and all-cause mortality.

Methods

Study of clinical significance of PR prolongation in ambulatory pts
Prospective, community-based cohort of 7575 pts from Framingham Heart Study (mean age, 47 yrs; 54% women)
Routine 12-lead electrocardiography for all pts
Prospective follow-up through 2007 from baseline examinations in 1968-1974
Multivariable-adjusted Cox proportional hazards models for associations of PR interval with the incidence of arrhythmic events and death
Main outcome measures: incident AF, pacemaker implantation, and all-cause mortality

Results

During follow-up, AF in 481, pacemaker implantation in 124, death on 1739 pts
At baseline, PR intervals >200 ms for 124 pts
On comparison of pts with PR intervals >200 ms vs ≤200 ms, incidence rates per 10,000 person-yrs: 140 vs 36 for AF, 59 vs 6 for pacemaker implantation, and 334 vs 129 for all-cause mortality
Corresponding absolute risk increases: 1.04% (AF), 0.53% (pacemaker implantation), 2.05% (all-cause mortality) per yr
On multivariable analyses, each 20-ms increment in PR associated with adjusted hazard ratio (HR) of 1.11 for AF, 1.22 for pacemaker implantation, and 1.08 for all-cause mortality
Pts with first-degree atrioventricular block had a 2-fold adjusted risk of AF, 3-fold adjusted risk of pacemaker implantation, and 1.4-fold adjusted risk of all-cause mortality

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