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Letters
November 11, 2009

Outcomes in Patients With Prolonged PR Interval or First-Degree Atrioventricular Block

JAMA. 2009;302(18):1967-1968. doi:10.1001/jama.2009.1603

To the Editor: In their cohort study using patients from the Framingham Heart Study, Dr Cheng and colleagues1 found that prolongation of the PR interval or first-degree atrioventricular (AV) block was associated with increased risks of atrial fibrillation (AF), pacemaker implantation, and all-cause mortality. In their AF analysis, they adjusted for electrocardiographic left ventricular hypertrophy (LVH) as a confounder, consistent with an article from the LIFE study that showed the relationship between LVH and AF.2 However, a subsequent article3 from the LIFE study reported that regression of LVH was associated with reduction of sudden cardiac death, and LVH has been reported to be a risk factor for cardiovascular mortality.4

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