First-degree atrioventricular block is associated with advanced atrioventricular block, atrial fibrillation and left ventricular dysfunction in patients with hypertension

Reklou, Andromachi; Lazaridis, Αntonios; Nikolaidou, Barbara; Kadiltzoglou, Paschalis; Doumas, Michael

doi:10.1097/hjh.0000000000000141

Cited by 16 publications

(15 citation statements)

References 36 publications

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“…27 Moreover, PR prolongation was a precursor of more severe degrees of AV conduction block (HR 2.7) with potential need for pacing. 26 Furthermore, several studies showed a higher risk for all-cause mortality with a prolonged PR interval (HR 1.3-1.6) (Figure 2C). 5,11,27 In one of these studies, each 20 ms increment in PR interval was associated with 10% increase in all-cause mortality.…”

Section: Clinical Evidence For Atrioventricular-dromotropathy In Hear...mentioning

confidence: 92%

“…Studies showed a 39-51% increased risk of HF in patients with prolonged PR interval (Figure 2B). 5,23,26 The PR interval also significantly predicted LV dysfunction in patients with newly developed PR prolongation during the followup period. 26 In a prospective study of 938 patients with stable coronary heart disease from the Heart and Soul Study, a prolonged PR interval was associated with a higher risk of HF hospitalization (HR 2.3) compared with a normal AV conduction (Table 1).…”

Section: Clinical Evidence For Atrioventricular-dromotropathy In Hear...mentioning

confidence: 95%

“…5,23,26 The PR interval also significantly predicted LV dysfunction in patients with newly developed PR prolongation during the followup period. 26 In a prospective study of 938 patients with stable coronary heart disease from the Heart and Soul Study, a prolonged PR interval was associated with a higher risk of HF hospitalization (HR 2.3) compared with a normal AV conduction (Table 1). 27 Moreover, PR prolongation was a precursor of more severe degrees of AV conduction block (HR 2.7) with potential need for pacing.…”

Section: Clinical Evidence For Atrioventricular-dromotropathy In Hear...mentioning

confidence: 95%

“…22 However, other studies suggested that PR prolongation is related to a poorer prognosis. 5,11,[23][24][25][26][27][28] Interestingly, the studies with relatively healthy individuals and a prolonged PR interval found the lowest risk for worse outcomes (Table 1). Additionally, a meta-analysis by Kwok et al 5 about PR prolongation and adverse outcomes, showed lower risks for HF in studies with a healthy population (HR 1.4) compared with studies including patients with cardiovascular diseases (HR 1.5).…”

Section: Haemodynamic Implications Of Prolonged Pr Intervalmentioning

confidence: 99%

“…23,24 Other studies found a two-fold risk to develop AF in patients with baseline PR prolongation compared with normal PR interval (Table 1). 11,26 Several studies showed that a prolonged PR interval was associated with a higher risk of HF or LV dysfunction and HF hospitalization, compared with a normal PR interval. Studies showed a 39-51% increased risk of HF in patients with prolonged PR interval (Figure 2B).…”

Section: Clinical Evidence For Atrioventricular-dromotropathy In Hear...mentioning

confidence: 99%

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Atrioventricular dromotropathy: evidence for a distinctive entity in heart failure with prolonged PR interval?

et al. 2017

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Heart failure (HF) is often accompanied by atrioventricular (AV) conduction disturbance, represented by prolongation of the PR interval on the electrocardiogram. Studies suggest that PR prolongation exists in at least 10% of HF patients, and it seems more prevalent in the presence of prolonged QRS duration. A prolonged PR interval may result in elevated left ventricular (LV) end-diastolic pressure, diastolic mitral regurgitation, and reduced LV pump function. This seems especially the case in patients with heart disease, in whom it is associated with an increased risk for atrial fibrillation, advanced AV heart block, HF, and death. These findings point towards the importance of proper AV coupling in HF patients. A few studies, strongly differing in design, suggest that restoration of AV coupling in patients with PR prolongation by pacing improves cardiac function and clinical outcomes. These observations argue for AV-dromotropathy as a potential target for pacing therapy, but other studies show inconsistent results. Given its potential clinical implications, restoration of AV coupling by pacing warrants further investigation. Additional possible future research goals include assessing different techniques to measure compromised AV coupling, determine the best site(s) of ventricular pacing, and assess a potential influence of diastolic mitral regurgitation in the efficacy of such therapy.

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Section: Clinical Evidence For Atrioventricular-dromotropathy In Hear...mentioning

confidence: 92%

Section: Clinical Evidence For Atrioventricular-dromotropathy In Hear...mentioning

confidence: 95%

Section: Clinical Evidence For Atrioventricular-dromotropathy In Hear...mentioning

confidence: 95%

Section: Haemodynamic Implications Of Prolonged Pr Intervalmentioning

confidence: 99%

Section: Clinical Evidence For Atrioventricular-dromotropathy In Hear...mentioning

confidence: 99%

See 3 more Smart Citations

Atrioventricular dromotropathy: evidence for a distinctive entity in heart failure with prolonged PR interval?

et al. 2017

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First-degree atrioventricular block is significantly associated with incident atrial fibrillation in the population predominantly including participants aged ≥ 60 years

et al. 2021

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PR prolongation as a predictor of atrial fibrillation onset: A state-of-the-art review

Ali,

Bhuiyan,

Vyas

et al. 2024

Current Problems in Cardiology

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First-degree atrioventricular block is associated with advanced atrioventricular block, atrial fibrillation and left ventricular dysfunction in patients with hypertension

Cited by 16 publications

References 36 publications

Atrioventricular dromotropathy: evidence for a distinctive entity in heart failure with prolonged PR interval?

Atrioventricular dromotropathy: evidence for a distinctive entity in heart failure with prolonged PR interval?

First-degree atrioventricular block is significantly associated with incident atrial fibrillation in the population predominantly including participants aged ≥ 60 years

PR prolongation as a predictor of atrial fibrillation onset: A state-of-the-art review

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