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Electrocardiographic Preexcitation and Risk of Cardiovascular Morbidity and Mortality: Results From the Copenhagen ECG Study

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BACKGROUND: The majority of available data on the clinical course of patients with ventricular preexcitation in the ECG originates from tertiary centers. We aimed to investigate long-term outcomes in individuals from a primary care population with electrocardiographic preexcitation.

METHODS AND RESULTS: Digital ECGs from 328 638 primary care patients were collected during 2001 to 2011. We identified 310 individuals with preexcitation (age range, 8-85 years). Data on medication, comorbidity, and outcomes were collected from Danish nationwide registries. The median follow-up time was 7.4 years (quartiles, 4.6-10.3 years). Compared with the remainder of the population, patients with preexcitation had higher adjusted hazards of atrial fibrillation (hazard ratio [HR], 3.12; 95% confidence interval [CI], 2.07-4.70) and heart failure (HR, 2.11; 95% CI, 1.27-3.50). Subgroup analysis on accessory pathway location revealed a higher adjusted hazard of heart failure for a right anteroseptal accessory pathway (HR, 5.88; 95% CI, 2.63-13.1). There was no evidence of a higher hazard of death among individuals with preexcitation when looking across all age groups (HR, 1.07; 95% CI, 0.68-1.68). However, a statistically significant (P=0.01) interaction analysis (<65 versus ≥65 years) indicated a higher hazard of death for patients with preexcitation ≥65 years (HR, 1.85; 95% CI, 1.07-3.18).

CONCLUSIONS: In this large ECG study, individuals with preexcitation had higher hazards of atrial fibrillation and heart failure. The higher hazard of heart failure seemed to be driven by a right anteroseptal accessory pathway. Among elderly people, we found a statistically significant association between preexcitation and a higher hazard of death.

Original languageEnglish
JournalCirculation: Arrhythmia and Electrophysiology
Volume10
Issue number6
Pages (from-to)e004778
ISSN1941-3149
DOIs
Publication statusPublished - Jun 2017

    Research areas

  • Accessory Atrioventricular Bundle, Action Potentials, Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Atrial Fibrillation, Cause of Death, Child, Denmark, Electrocardiography, Female, Heart Conduction System, Heart Failure, Heart Rate, Humans, Male, Middle Aged, Pre-Excitation Syndromes, Predictive Value of Tests, Prevalence, Primary Health Care, Prognosis, Proportional Hazards Models, Registries, Risk Assessment, Risk Factors, Sex Factors, Time Factors, Young Adult, Journal Article

ID: 51638156