Abstract Details

Title Utility of Pre-sepsis P-wave Terminal Force in Lead V1 (PTFV1) as a Predictor of Atrial Fibrillation and Ischemic Stroke in Patients with Sepsis

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S53 - Stroke Prevention (3:54 PM-4:06 PM)

Poster/Presentation
Number 003

Objective Our goal was to determine if elevated PTFV1 pre-sepsis was associated with new onset atrial fibrillation (AF), AF with rapid ventricular rate (RVR), or ischemic stroke (IS) in sepsis patients.

Background Enlarged P-wave terminal force in lead V1 (PTFV1) >5000 μV*ms is a long-term predictor of the of AF and IS. Sepsis patients are at high risk of cardiac dysfunction, AF, and IS, but the predictive value of pre-sepsis PTFV1 in this high risk population is unknown.

Design/Methods Patients with acute sepsis were prospectively screened and enrolled in an observational study years 2015-2019. Of the 360 consented, 272 pre-sepsis electrocardiograms (ECG) were evaluable. PTFV1 was measured using the Mitutoyo 500-195-30CAL Absolute Digimatic Caliper. Charts were reviewed for documentation of AF, RVR, any historical events of IS, and IS post-sepsis. Statistical significance was evaluated using logistic regression.

Results In this cohort, the median age was 63 years [IQR 53-71], 44% women. The median PTFV1 at pre-sepsis was 3219 μV*ms [0 – 5487], 32% PTVF1V ≥ 5000 μV*ms. New onset AF occurred in 44; 61 developed AF with RVR; 30 had a history of IS; 13 developed a new IS after enrollment. Patients who developed AF with RVR were more likely to have a history of IS or develop a new IS p=0.0137, odds ratio 2.41 (95% confidence interval 1.20 - 4.85), but there was no association with new onset AF and IS post-sepsis. Pre-sepsis PTVF1V ≥ 5000 μV*ms was not significantly associated with occurrence of new onset AF, AF with RVR, or IS with p value's > 0.05 for all 3 associations.

Conclusions

These preliminary results confirm the high prevalence of AF among sepsis patients. While PTFV1 was not associated with AF or IS in this population, the association of RVR during sepsis with events of IS pre-or post-sepsis, should be studied further with multivariate analysis.

Authors/Disclosures
Aisha Elfasi, MD PRESENTER	Dr. Elfasi has nothing to disclose.
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Alexis N. Simpkins, MD, PhD, MSCR, FAAN (Cedars-Sinai Medical Center, Dept of Neurology)	Dr. Simpkins has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for National Institute of Neurological Disorders and Stroke Data Safety Monitoring Board. Dr. Simpkins has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Stroke: Vascular and Interventional Neurology. The institution of Dr. Simpkins has received research support from NIH/NIA. The institution of Dr. Simpkins has received research support from Bristol-Meyer Squibb Foundation. Dr. Simpkins has received publishing royalties from a publication relating to health care.

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