Chest
An Epidemiologic Study of First Degree Atrioventricular Block in Tecumseh, Michigan
Section snippets
METHODS
Tecumseh, Michigan is the site of a prospective epidemiologic study of chronic disease, particularly cardiovascular disease, in a total natural community. Details of these investigations have been published previously.15, 16, 17, 18
In 1959 and 1960 8,641 persons, 88 percent of the entire population of the community, participated in the first series of examinations. All participants gave detailed medical histories and had thorough physical examinations which were performed by experienced members
Prevalence of atrioventricular block (Table 1)
First degree atrioventricular block was not detected among participants less than 20 years of age. Prevalence rates were low among both men and women during the third through sixth decades, but rose progressively in the succeeding decades.
Empty Cell Empty Cell Empty Cell Empty Cell Empty Cell Age Groups Empty Cell Empty Cell Empty Cell Empty Cell Empty Cell Empty Cell 20–29 30–39 40–49 50–59 60–69 70–79 80 + Total Number examined 453 679 467 331 178 101 26 2235 Men Number with long PR interval 5 10 9 1 9 9 6 49 Rate per 1000 11.0 14.7 19.3 3.0 50.6 89.1 230.8
DISCUSSION
First degree atrioventricular heart block was not observed in the electrocardiograms of any participants less than 20 years of age during the first series of examinations in Tecumseh, Michigan. The prevalence of prolonged PR intervals was only 13 per 1,000 among the 4,015 persons from 20 through 59 years of age with no appreciable difference between the sexes or from one decade to another. The prevalence increased sharply in the succeeding decades, so that 43 of the 95 participants with delayed
ACKNOWLEDGMENT
The authors are grateful to Dr. Frederick H. Epstein, Director of the Tecumseh Community Health Study, for his helpful advice and suggestions, to Mr. John Napier, Associate Director for Field Operations, for his Help in assembling the data and to the entire staff for their efforts in collecting the comprehensive information about the study population.
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Cited by (27)
PR prolongation as a predictor of atrial fibrillation onset: A state-of-the-art review
2024, Current Problems in CardiologyEpidemiology and Outcomes Associated with PR Prolongation
2023, Cardiology ClinicsProlonged PR interval and incidence of atrial fibrillation, heart failure admissions, and mortality in patients with implanted cardiac devices: A real-world survey
2023, Heart Rhythm O2Citation Excerpt :The PR interval measures the time from the beginning of atrial depolarization to the onset of ventricular depolarization (1). Prolonged PR interval defined as PR interval > 200 milliseconds (ms), also known as first degree atrioventricular block, is commonly seen in the general population, with higher prevalence in older individuals (2). The prevalence of prolonged PR interval across different studies ranged from 2% to 14%, with overall mean prevalence of 7% (3).
Epidemiology and Outcomes Associated with PR Prolongation
2021, Cardiac Electrophysiology ClinicsCitation Excerpt :The etiologies of PR prolongation include organic heart disease from ischemia, inflammatory and infiltrative diseases, medications, autonomic influences, and collagen vascular disorders as well as idiopathic causes in patients without a history of cardiovascular disease. Although PR prolongation has classically been considered a benign finding, many of the original studies analyzing outcomes in patients with PR prolongation are confounded by selection bias including enrollment of primarily healthy, young male subjects with low burden of comorbid medical conditions.2–6 More contemporary analyses have linked PR prolongation with adverse outcomes including progression of conduction system disease, increased risk of atrial remodeling and atrial arrhythmias,7,8 and increased risk of all-cause mortality.9
Outcomes Related to First-Degree Atrioventricular Block and Therapeutic Implications in Patients with Heart Failure
2016, JACC: Clinical ElectrophysiologyCitation Excerpt :The authors did not report the percentage of participants who developed new PR prolongation during follow-up. An epidemiological study of PR interval duration in the 4,678 men and women in Tecumseh, Michigan, showed no increase in mortality amongst the 2% of the population with PR ≥220 ms during mean follow-up of 4 years (3). Three other studies have similarly found first-degree AVB to be a benign condition in healthy adults (Table 1) (1,2,32).
This work was supported in part by the Cardiovascular Research Center under Program Project Grant HE-09814 from the National Heart Institute, National Institutes of Health, U.S. Public Health Service. Presented at the Conference on Cardiovascular Epidemiology, sponsored by the American Heart Association, National Heart Institute and Louisiana Heart Association, New Orleans, March 3–4, 1869.
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Formerly Instructor in Internal Medicine, University of Michigan; currently Assistant Professor of Medicine, Marquette School of Medicine, Milwaukee.
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Associate Professor of Internal Medicine.
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Research Associate in Epidemiology.
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International Postdoctoral Research Fellow (USPHS No 3F05–01-A1-S1).