Arrhythmias & electrophysiology
Natural history of the PR interval and risk of cardiac events and mortality: a nationwide study
Authors' conclusion
Prevalence of PR prolongation and temporal PR changes increased with age. Short, long and temporal changes in the PR interval were all associated with increased risk of cardiac events and all-cause mortality.
Study context
- Population
- Individuals with nationwide hospital ECGs in Denmark9,020,051 ECGs, 53% female, 1,213,073 patients having >1 ECG
- Participants
- 2,234,492 individuals
- Exposure
- Index-PR interval and absolute temporal changes in PR interval (ΔPR) in relation to cardiac events
- Outcome
- Atrial fibrillation/flutter, heart failure and ventricular arrhythmias by index-PR interval
Methodological detailsNationwide hospital ECGs linked with Danish national registries, multivariable cause-specific Cox models
- Nationwide hospital ECGs linked with Danish national registries
- Multivariable cause-specific Cox models
Main finding
As reported in the abstract
U-shaped HR pattern; atrial fibrillation/flutter HR
1.03-1.24
Heart failure HR
1.04-1.11
Ventricular arrhythmias HR
1.08-1.16
Observational data: associations, not effects.
Further findings
Syncope by index-PR interval
- Stepwise increase at PR interval ≥170 ms, HR
- 1.08-1.36
- p<0.001
High-degree atrioventricular block/cardiac device implantation by index-PR interval
- Linear increasing at PR intervals >160 ms, HR
- 1.07-2.11
- p<0.05
All-cause mortality by index-PR interval
- J-shaped; shortest PR intervals HR
- 1.44
- Longest PR intervals HR
- 1.03
- p<0.001 for each
Cardiac events by ΔPR
- Stepwise increases in HR for all events
Descriptive PR interval characteristics · Median follow-up 7.1 years
- Median index-PR interval
- 158 ms
- PR interval <120 ms
- 2.9%
- PR interval >200 ms
- 7.4%
- Median ΔPR
- 10 ms
- Prevalence of prolonged PR interval increased with age
- ΔPR highest among the oldest
Original publication
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