ArticleAmerican heart journal2015
P-wave indices and atrial fibrillation: cross-cohort assessments from the Framingham Heart Study (FHS) and Atherosclerosis Risk in Communities (ARIC) study.
Article in American heart journal, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 5 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
54 citing papers in PubMed, 5 syntheses or guidelines pooled it, 106 citations in OpenAlex.
- Electrocardiographic Predictors of Atrial Fibrillation.Medical sciences (Basel, Switzerland) · 2023Pooled it
- Genetic Determinants of Electrocardiographic P-Wave Duration and Relation to Atrial Fibrillation.Circulation. Genomic and precision medicine · 2020Pooled it
- Predictive value of P wave terminal force in lead V1 for atrial fibrillation: A meta-analysis.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2020Pooled it
- Prediction models for atrial fibrillation applicable in the community: a systematic review and meta-analysis.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2020Pooled it
- Fifteen Genetic Loci Associated With the Electrocardiographic P Wave.Circulation. Cardiovascular genetics · 2017Pooled it
- Electrocardiographic and Echocardiographic predictors of paroxysmal atrial fibrillation detected after ischemic stroke.BMC cardiovascular disorders · 2016Trial
- Effect of Intensive Blood Pressure Lowering on Incident Atrial Fibrillation and P-Wave Indices in the ACCORD Blood Pressure Trial.American journal of hypertension · 2016Trial
- [Atrial fibrillation screening-reading the P-wave].Innere Medizin (Heidelberg, Germany) · 2026Review
- Assessment of Autonomic Nervous System Function in Patients with Aortic Stenosis and Diabetes Mellitus.Diagnostics (Basel, Switzerland) · 2026Article
- Right and Left Atrial Dysfunction as Independent Cardiovascular Risk Factors: A UK Biobank Study.Circulation. Arrhythmia and electrophysiology · 2026Article
- Artificial intelligence for atrial fibrillation prediction while in sinus rhythm: a narrative review.European heart journal. Digital health · 2026Review
- Prevalence, associated factors, and prognostic value of P wave abnormality in patients with coronary artery disease.International journal of cardiology. Cardiovascular risk and prevention · 2025Article
- P-Wave Indices and the Risks of Incident Atrial Fibrillation and Ischemic Stroke in Black Adults: The Jackson Heart Study.Journal of the American Heart Association · 2025Article
- Electrocardiographic P-wave indices and onset of atrial fibrillation and histological fibrosis in a general Japanese population: a prospective cohort analysis of the Hisayama Study.European heart journal open · 2025Article
- New-Onset Atrial Fibrillation During ST-Segment-Elevation Myocardial Infarction: Risk of Recurrence and Its Clinical Impact During 10 Years of Follow-Up.Journal of the American Heart Association · 2025Article
- Newly Diagnosed Atrial Fibrillation Indicators in Cryptogenic Stroke Survivors' P-Wave Indices: A Systematic Review and Meta-Analysis.Journal of arrhythmia · 2025Article
- Cisd2 delays atrial aging via a modulation of calcium homeostasis that mitigates atrial myopathy.Cell communication and signaling : CCS · 2025Article
- Applying multimodal AI to physiological waveforms improves genetic prediction of cardiovascular traits.American journal of human genetics · 2025Article
- Efficacy of an alternative positioning of intracardiac defibrillation catheters in atrial fibrillation ablation.Journal of arrhythmia · 2025Article
- P-Wave Duration Is Associated With Aging Patterns in Structural Brain Networks.Journal of the American Heart Association · 2024Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundAtrial fibrillation (AF) is associated with increased morbidity. P-wave indices (PWIs) measure atrial electrical function and are associated with AF. Study of PWI has been limited to single-cohort investigations, and their contributions to risk enhancement are unknown.
methodsWe examined PWI from the FHS and ARIC study. We calculated 10-year AF risk using adjusted Cox models. We conducted cross-cohort meta-analyses for the PWI estimates and assessed their contributions to risk discrimination (c statistic), net reclassification index, and integrated discrimination improvement.
resultsAfter exclusions, the analysis included 3,110 FHS (62.6 ± 9.8 years, 56.9% women) and 8,254 ARIC participants (62.3 ± 5.6 years, 57.3% women, 20.3% black race). Over 10 years, 217 FHS and 458 ARIC participants developed AF. In meta-analysis, P-wave duration >120 milliseconds was significantly associated with AF (hazard ratio 1.55, 95% CI 1.29-1.85) compared with ≤120 milliseconds. P-wave area was marginally but not significantly related to AF (hazard ratio 1.31, 95% CI 0.95-1.80). P-wave terminal force was strongly associated with AF in ARIC but not FHS. P-wave indices had a limited contribution toward predictive risk beyond traditional risk factors and markers.
conclusionsP-wave indices are intermediate phenotypes for AF. They are associated with AF in cross-cohort meta-analyses but contribute minimally toward enhancing risk prediction.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.