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First-degree atrioventricular block is associated with advanced atrioventricular block, atrial fibrillation, and left ventricular dysfunction in patients with hypertension

 Jae-Sun Uhm  ;  Jaemin Shim  ;  Jin Wi  ;  Hee-Sun Mun  ;  Junbeom Park  ;  Sung-Ha Park  ;  Boyoung Joung  ;  Hui-Nam Pak  ;  Moon-Hyoung Lee 
 JOURNAL OF HYPERTENSION, Vol.32(5) : 1115-1120, 2014 
Journal Title
Issue Date
Adult ; Atrial Fibrillation/complications* ; Atrioventricular Block* ; Female ; Humans ; Hypertension/complications* ; Male ; Middle Aged ; Ventricular Dysfunction, Left/complications*
atrial fibrillation ; atrioventricular block ; left ventricular dysfunction ; PR interval
OBJECTIVES: Clinical significance of first-degree atrioventricular block (AVB) have not been known in patients with hypertension. This study was performed to elucidate long-term prognosis of first-degree AVB in patients with hypertension. METHODS: We included 3816 patients (mean age, 61.0 ± 10.6 years; men, 47.2%) with hypertension. We reviewed their ECGs and measured the PR interval. The patients were divided into two groups: normal PR interval (120 ms ≤ PR ≤200 ms) and first-degree AVB (PR >200 ms). We compared the incidence, cumulative incidence and hazard ratios of advanced AVB, sick sinus syndrome, atrial fibrillation and left ventricular dysfunction between the two groups during the follow-up period. RESULTS: The prevalence of first-degree AVB in patients with hypertension was 14.3%. The patients were followed up for 9.4 ± 2.4 years. Incidence and cumulative incidence of advanced AVB, atrial fibrillation and left ventricular dysfunction in patients with first-degree AVB were significantly higher than in patients with normal PR interval. By multivariate Cox's regression, patients with first-degree AVB had an increased risk of advanced AVB [hazard ratio 2.77; 95% confidence interval (95% CI) 1.38-5.59; P = 0.004], atrial fibrillation (hazard ratio 2.33; 95% CI 1.84-2.94; P < 0.001) and left ventricular dysfunction (hazard ratio 1.49; 95% CI 1.11-2.00; P = 0.009). However, sick sinus syndrome was not associated with first-degree AVB. CONCLUSION: First-degree AVB is an independent risk factor for future development of advanced AVB, atrial fibrillation and left ventricular dysfunction in patients with hypertension.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Mun, Hee Sun(문희선)
Park, Sung Ha(박성하) ORCID logo https://orcid.org/0000-0001-5362-478X
Park, Jun Beom(박준범)
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Shim, Jae Min(심재민)
Uhm, Jae Sun(엄재선) ORCID logo https://orcid.org/0000-0002-1611-8172
Wi, Jin(위진) ORCID logo https://orcid.org/0000-0003-0655-5130
Lee, Moon Hyoung(이문형) ORCID logo https://orcid.org/0000-0002-7268-0741
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
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