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

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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.

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Acknowledgements

YT was supported by American Heart Association Strategically Focused Research Network (SFRN), 18SFRN34110170.

Funding

American Heart Association award as above.

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Authors and Affiliations

  1. Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 North Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA

    Yoshihiro Tanaka, Ravi B. Patel & Philip Greenland

  2. Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, 920-8641, Japan

    Yoshihiro Tanaka, Hayato Tada, Kenshi Hayashi, Kan Yamagami, Masayuki Takamura & Masa-aki Kawashiri

  3. Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Rikuta Hamaya

  4. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Rikuta Hamaya

  5. Department of Cardiology, Tokyo Medical and Dental University, Tokyo, Japan

    Rikuta Hamaya

  6. Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Ravi B. Patel

  7. Kanazawa Medical Association, Kanazawa, Japan

    Atsushi Hashiba

Authors
  1. Yoshihiro Tanaka
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  2. Hayato Tada
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  9. Masa-aki Kawashiri
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Correspondence to Yoshihiro Tanaka.

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Supplementary Information

380_2021_1805_MOESM1_ESM.tiff

Supplementary file1. Supplemental Figure 1 Comparison of standardized mean differences in baseline characteristics before and after adjusting for IPW. Standardized mean differences in baseline characteristics were poorly balanced before IPW adjustment, while they were well balanced after IPW adjustment. All standardized mean differences after IPW adjustment were within the range from − 0.1 to 0.1 (dashed lines). AHT antihypertensive treatment, BP blood pressure, CAD coronary artery disease, eGFR estimated glomerular filtration rate, f-AVB first-degree atrioventricular block, HDL-C high density lipoprotein cholesterol, IPW inverse probability weighting, LVH left ventricular hypertrophy, PAC premature atrial contraction. (TIFF 3168 KB)

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Tanaka, Y., Tada, H., Hamaya, R. et al. First-degree atrioventricular block is significantly associated with incident atrial fibrillation in the population predominantly including participants aged ≥ 60 years. Heart Vessels 36, 1401–1409 (2021). https://doi.org/10.1007/s00380-021-01805-2

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