BACKGROUND Sex-related electrocardiographic differences are a well-known phenomenon, but not their expression in patients with atrial fibrillation (AF). In this study we aim to assess the presence of significant sex-related differences in ECG features, with particular attention to P-wave parameters, of a large cohort of patients affected by different types of AF. METHODS A 5-min resting 16-lead ECG was evaluated for 1119 AF patients in sinus rhythm. The durations of the main ECG waves and intervals were measured for both atrial and ventricular activity. Moreover, the beat-to-beat P-wave variability was computed for lead II and for the first principal component (PC1) computed across the 16 leads. The percentage of variance explained by PC1 was computed. RESULTS Males compared to females showed significantly longer RR interval (1.02 ± 0.16 s vs 0.97 ± 0.15 s, p < .001), PQ interval (191 ± 34 ms vs 183 ± 35 ms, p = .008), QRS duration (105 ± 17 ms vs 98 ± 13 ms, p = .021), significantly lower percentage of variance explained by PC1 and P-wave variability. Males with paroxysmal AF compared to females with paroxysmal AF had significantly longer RR interval (1.01 ± 0.17 s vs 0.96 ± 0.14 s, p < .001), shorter QTc (388 ± 27 ms vs 402 ± 27 ms, p < .001), lower P-wave variability in PC1. Males with persistent AF compared to females with persistent AF had significantly shorter QTc interval (396 ± 30 ms vs 407 ± 26 ms, p = .019), longer PQ interval (194 ± 35 ms vs 182 ± 30 ms, p = .037), higher V1 terminal force (2.1 ± 1.2 mV*ms vs 1.8 ± 1 mV*ms, p = .007), lower percentage of variance explained by PC1. CONCLUSIONS AF patients present with several sex-related ECG differences. Consequently, sex should be taken into account when developing ECG algorithms identifying patients at risk for AF progression.

中文翻译：

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不同类型房颤患者的性别相关心电图差异：SWISS-AF研究的结果。

背景技术与性别有关的心电图差异是一种众所周知的现象，但在心房颤动（AF）患者中并非如此。在这项研究中，我们旨在评估一大批受不同类型房颤影响的患者的心电图特征中存在明显的性别相关差异，尤其要注意P波参数。方法对1119名房颤患者的窦律进行5分钟静息16导联心电图评估。测量主要心电图波的持续时间和间隔的心房和心室活动。此外，针对导线II和针对16条导线计算出的第一主成分（PC1），计算了逐拍P波变异性。计算由PC1解释的方差百分比。结果男性相比女性表现出更长的RR间隔（1.02±0.16 s vs. 0）。97±0.15 s，p <.001），PQ间隔（191±34 ms vs 183±35 ms，p = .008），QRS持续时间（105±17 ms vs 98±13 ms，p = .021）较低的方差百分比由PC1和P波变异性解释。患有阵发性AF的男性与患有阵发性AF的女性相比，RR间隔明显更长（1.01±0.17 s vs 0.96±0.14 s，p <.001），QTc更短（388±27 ms vs 402±27 ms，p <.001） ，降低PC1中的P波波动性。患有持续性房颤的男性与持续性房颤的女性相比，QTc间隔明显缩短（396±30 ms vs 407±26 ms，p = .019），PQ间期较长（194±35 ms vs 182±30 ms，p = .037） ），较高的V1终端力（2.1±1.2 mV * ms与1.8±1 mV * ms，p = .007），较低的方差百分比由PC1解释。结论AF患者表现出几种性别相关的心电图差异。所以，