Electrocardiogram characteristics and risk of atrial fibrillation among patients with sarcoidosis
M Herskind, S Godtfredsen, K Kragholm, S Riahi, S Riddersholm, M PosborgAbstract
Introduction
Sarcoidosis is associated with increased risk of atrial fibrillation. This study examined whether baseline electrocardiogram (ECG) abnormalities are associated with atrial fibrillation in patients with sarcoidosis.
Methods
Sarcoidosis cases identified in the Danish National Patient Registry were linked to the Danish Nationwide ECG Cohort which includes all ECGs recorded in Denmark from 2000 to 2022. Individuals with prior atrial fibrillation were excluded. Cases were matched 1:4 to controls by age, sex, and date of ECG. Follow-up started at date of ECG and continued until the occurrence of atrial fibrillation, death, emigration, or the end of the study period (26-05-2023). The population was divided into groups based on specific patterns of ECG and hazard ratios adjusted for history of heart failure, hypertension, diabetes and ischaemic heart disease were estimated using Cox regression.
Results
We identified 9,893 sarcoid patients and 39,289 matched controls. Mean age at sarcoid diagnosis was 53.7. Mean follow-up was 8.3 years. The 10-year cumulative incidence of atrial fibrillation was 10.3% in sarcoidosis patients and 7.3% in controls. Biphasic P-wave (HR 1.29), short P-wave duration <120ms (HR 1.32), elevated P-terminal force >6000ms·mV (HR 1.55), and prolonged PR interval >220ms (HR 1.61) were associated with increased risk.
Conclusion
Patients with sarcoidosis had an elevated risk of atrial fibrillation, and the presence of baseline ECG abnormalities was associated with additional increase in risk.Cumulative IncidensForrestplot of ECG patterns