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The high prevalence of sick sinus syndrome and atrial fibrillation in LBD suggests the presence of disease-related atrial conduction disorders. To explore whether LBD is associated with atrial conduction disorders, electrocardiographic (ECG) P wave parameters were analyzed in a cohort of LBD patients (n\u2009=\u200974), using age-matched Alzheimer\u2019s disease (AD) patients (n\u2009=\u200925) as controls. P wave terminal force in V1 and P wave duration were found to be significantly greater in the LBD group than in the AD group. In addition, 43 (58%) individuals in the LBD exhibited pathological P wave terminal force (&gt;\u20094000\u00a0\u00b5V*ms) vs 3 (12%) in the AD group, and 60 (81%) in the LBD group exhibited pathological P wave duration (\u2265\u2009120\u00a0ms), vs 13 (52%) in the AD group. The difference could not be explained by atrial fibrillation or atrial enlargement on echocardiogram. The clinical significance of pathological P wave parameters in LBD is unknown, but their presence suggests an atrial cardiomyopathy that could be due to cardiac alpha-synuclein deposition, autonomic dysfunction, or a combination thereof. Future research is warranted to elucidate whether this proposed disease-related atrial cardiomyopathy is related to cardiac alpha-synuclein deposition, whether it is causally related to cardiac complications in LBD, and whether pathological P wave parameters hold potential as a screening tool for cardiac complications in LBD.<\/jats:p>","DOI":"10.1007\/s11357-024-01479-4","type":"journal-article","created":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T17:15:43Z","timestamp":1736529343000},"page":"3169-3176","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["High prevalence of atrial conduction abnormalities in Lewy body disease \u2013 a marker of cardiac complications?"],"prefix":"10.1007","volume":"47","author":[{"given":"Keivan","family":"Javanshiri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Siotis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isak","family":"Heyman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7045-0005","authenticated-orcid":false,"given":"Mattias","family":"Haglund","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,10]]},"reference":[{"key":"1479_CR1","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1016\/j.brainres.2017.09.033","volume":"1702","author":"DS Goldstein","year":"2019","unstructured":"Goldstein DS, Sharabi Y. 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