Intraventricular Conduction Delay in a Standard 12-Lead Electrocardiogram as a Predictor of Mortality in General Population.
Circ Arrhythm Electrophysiol. 2011 Aug 13;
Authors: Aro AL, Anttonen O, Tikkanen JT, Junttila MJ, Kerola T, Rissanen HA, Reunanen A, Huikuri HV
BACKGROUND: -Prolonged duration of QRS complex (QRSd) in a 12-lead electrocardiogram (ECG) is associated with adverse prognosis in patients with cardiac disease, but its significance is not well established in general population. In particular, there is paucity of data on the prognostic significance of nonspecific intraventricular conduction delay (IVCD) in apparently healthy subjects. METHODS AND RESULTS: -We evaluated the 12-lead ECGs of 10899 Finnish middle-aged subjects from the general population (52% males, mean age 44±8.5 years) between 1966 and 1972 and followed them for 30±11 years. Primary end points were all-cause mortality, cardiac mortality, and arrhythmic death. Prolonged QRSd was defined as QRS ? 110 ms and IVCD as QRS ? 110 ms without the criteria of complete or incomplete bundle branch block. QRSd ? 110 ms was present in 1.3% (N=147) and IVCD in 0.6% (N=67) of the subjects. Prolonged QRSd predicted all-cause mortality (multivariate adjusted relative risk [RR] 1.48; 95% confidence interval [CI] 1.22-1.81; P<0.001), cardiac mortality (RR 1.94; CI 1.44-2.63; P<0.001), and sudden arrhythmic death (RR 2.14; CI 1.38-3.33; P=0.002). Subjects with IVCD had increased all-cause mortality (RR 2.01; CI 1.52-2.66; P<0.001), cardiac mortality (RR 2.53; CI 1.64-3.90; P<0.001), and an elevated risk of arrhythmic death (RR 3.11; CI 1.74-5.54; P=0.001). LBBB also weakly predicted arrhythmic death (P=0.04), but RBBB was not associated with increased mortality. CONCLUSIONS: -Prolonged QRSd in a standard 12-lead ECG is associated with increased mortality in general population, IVCD being most strongly associated with an increased risk of arrhythmic death.
PMID: 21841194 [PubMed - as supplied by publisher]