Abstract 12803: Abnormal P-wave Terminal Force in Lead V1 Is Associated with Cardiac Death or Hospitalization for Heart Failure in Prior Myocardial Infarction

The prognostic significance of P-wave terminal force in lead V 1 (PTFV 1 ), a marker of left atrial overload, has not been fully investigated in patients with myocardial infarction (MI). Accordingly, we sought to clarify the prognostic significance of PTFV 1 in patients with prior MI. We retrospectively examined 185 patients with prior (> 6 months) MI. Patients with atrail fibrillation or flutter were excluded. The primary end point was cardiac death or hospitalization for heart failure. Abnormal PTFV 1 was defined as PTFV 1 ≥40 mm × msec. During a follow-up period of 6.4 ± 2.9 years, 39 patients developed the primary end point. A Kaplan-Meier analysis showed a lower primary event-free rate in 79 patients with abnormal PTFV 1 than in 106 with normal PTFV 1 (p 1 , loop diuretic use, and spironolactone use were significantly associated with the primary end point. A multivariate Cox regression analysis selected age (hazard ratio [HR] 1.09, 95% confidence interval [CI] 1.04 - 1.14, p 1 (HR 2.72, 95% CI 1.24 - 5.99, p = 0.01) as independent predictors of the primary end point. In conclusion, abnormal PTFV 1 is an independent predictor of cardiac death or hospitalization for heart failure in patients with prior MI. The analysis of P waves in lead V 1 would provide useful prognostic information in patients with prior MI.