Arrhythmias & electrophysiology
Prevalence and progression of P-wave abnormalities in patients with atrial fibrillation
Authors' conclusion
The prevalence and rate of progression of PWA are high in this cohort of AF patients, with development mainly driven by aging, chronic cardiovascular conditions, and frequent AF recurrences.
Study context
- Population
- Individuals undergoing the index cardioversion (CV) for acute atrial fibrillation (AF)individuals with a series of 3 sinus rhythm electrocardiograms (ECGs)
- Participants
- 1,316 individuals
- Comparison
- Normal P wave vs Moderate PWA vs Extensive PWA
- Outcome
- Progression from normal P wave to moderate and extensive PWAs
- Follow-up
- Between pre-CV and index CV ECGs
Main finding
As reported in the abstract
Between pre-CV and index CV ECGs
Progressed from normal P wave to moderate PWA
133 of 342
38.9%
Progressed from normal P wave to extensive PWA
54 of 342
15.8%
Further findings
Prevalence of P-wave status · At the end of follow-up
Progression from normal P wave to moderate and extensive PWAs · During the follow-up after index CV
- Progressed from normal P wave to moderate PWA
- 131 of 407 (32.2%)
- Progressed from normal P wave to extensive PWA
- 74 of 407 (18.2%)
Independent risk factors for persistent or progressive PWA status
- Increasing age, heart failure, hypertension, vascular disease, history of previous AF episodes, high CV frequency, left ventricular hypertrophy, and wide QRS complex in the ECG were independent risk factors
- Cox regression analysis
Original publication
Prevalence and progression of P-wave abnormalities in patients with atrial fibrillation. Heart Rhythm. Published 31 August 2025. doi:10.
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