Association between sleep disordered breathing and electrocardiographic markers of atrial abnormalities: The MESA study

Sleep disordered breathing (SDB) is a common condition increasingly recognized as a risk factor for atrial fibrillation (AF).1,2 Long P wave duration, an electrocardiographic (ECG) marker of atrial remodelling, was shown in patients with SDB highlighting the potential role of atrial remodelling in linking SDB to AF.3 This study was limited by small sample sizes of selected patients from sleep clinics. Emerging literature indicates that an ECG marker for P wave terminal force (PTF) identifies atrial abnormalities strongly linked to AF and stroke.4 However, the association between PTF and SDB has not been explored previously. Therefore, we sought to examine the association of ECG markers of left atrial (LA) abnormalities in relation to SDB in a large, representative population in this study, with a specific interest in PTF in V1(PTFV1) as a sensitive marker of LA abnormalities.