Arrhythmias & electrophysiology
Novel electrocardiographic classification for stroke prediction in atrial fibrillation patients undergoing cardioversion
Main finding · SSE (validation cohort)Result — go to the resultAdjusted hazard ratio 2.1 95% CI 1.4–3.1Authors' conclusion
Novel electrocardiographic PWA classification provided additional prognostic insight in AF patients.
Study context
- Population
- Atrial fibrillation (AF) patients undergoing acute cardioversion; validation in patients with no anticoagulationvalidation cohort 874
- Participants
- 1,773 patients
- Exposure
- Extensive PWA vs no extensive PWA
- Extensive PWAn = 219
- Outcome
- Stroke or systemic embolism (SSE)
- Follow-up
- 30 days after CV (derivation) and long term (validation)
Methodological detailsderivation and validation cohorts, histopathologic validation
- Derivation and validation cohorts
- Histopathologic validation
Main finding
SSE (validation cohort) · median follow-up 4.9 years
Adjusted hazard ratio
2.1
95% CI 1.4–3.1
P < 0.001
PWA
adjusted HR 2.1 (95% CI 1.4–3.1); P < 0.001
Per category, as printed
As reported in the abstract
- SSE in total
- 51 patients (5.8%)
Observational data: associations, not effects.
Further findings
| Outcome | PWA | CHA2DS2-VASc | PWA + CHA2DS2-VASc |
|---|---|---|---|
| AUC for SSE · 3 years | |||
| AUC | 0.77 | 0.79 | 0.86 |
Interstitial fibrosis (27 CAREBANK patients, histology)
- Extensive PWA associated with interstitial fibrosis
- P = 0.033
Original publication
Novel electrocardiographic classification for stroke prediction in atrial fibrillation patients undergoing cardioversion. Heart Rhythm. Published 26 April 2024. doi:10.
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