Interatrial block predicts atrial fibrillation in patients with carotid and coronary artery disease

Alexander, Bryce; Baranchuk, Adrián; Haseeb, Sohaib; Rooy, Henri van; Kuchtaruk, Adrian; Hopman, Wilma M.; Çinier, Göksel; Hétu, Marie-France; Li, Terry Y; Johri, Amer M.

doi:10.21037/jtd.2018.06.53

Cited by 11 publications

(4 citation statements)

References 22 publications

(21 reference statements)

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“…16 Moreover, Alexander et al demonstrated that low P wave amplitude in lead DI was linked to new-onset AF in the ACS population. 17 In our investigation, this P wave index was not shown to be associated with long-term AF in AIS cases. In addition, when compared with PWD, PWPT in lead DII and VI, it had the lowest AUC value, sensitivity, and specificity for long-term AF.…”

Section: Discussioncontrasting

confidence: 49%

Evaluation of electrocardiographic P wave parameters in predicting long-term atrial fibrillation in patients with acute ischemic stroke

Çınar¹,

Hayıroğlu²,

Selçuk³

et al. 2022

Arq Neuropsiquiatr

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Background Electrocardiographic parameters, such as P wave peak time (PWPT), P wave duration (PWD), and P wave amplitude in lead DI, have been utilized to assess left atrial anomalies linked to the development of atrial fibrillation (AF) in different cohort settings. Objective To compare electrocardiographic parameters, such as P waves, in predicting long-term AF risk in acute ischemic stroke cases. Methods The data of 231 consecutive acute ischemic stroke cases were retrospectively collected. Two independent cardiologists interpreted the electrocardiography recordings for PWPT, PWD, and P wave amplitude in lead DI. The median follow-up study period was 16 (interquartile range [IQR]: 11–24) months. Results In total, AF was detected in 43 (18.6%) cases. All studied P wave parameters were found to be statistically significant in cases with AF. Based on multivariable logistic regression analysis, dementia, left atrium volume index, PWD (razão de chances [RC]: 1.11; 95% confidence interval [CI]: 1.058–1.184; p = 0.003), PWPT in lead DII (RC: 1.030; 95%CI: 1.010–1.050; p = 0.003), and advanced interatrial block morphology were independent predictors of long-term AF. P wave duration had the highest area under the curve value, sensitivity, and specificity for long-term AF in such cases compared with the other P wave parameters. Conclusions Our head-to-head comparison of well-known P wave parameters demonstrated that PWD might be the most useful P wave parameter for long-term AF in acute ischemic stroke cases.

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Section: Discussioncontrasting

confidence: 49%

Evaluation of electrocardiographic P wave parameters in predicting long-term atrial fibrillation in patients with acute ischemic stroke

Çınar¹,

Hayıroğlu²,

Selçuk³

et al. 2022

Arq Neuropsiquiatr

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“…In the present study, we found that the significant predictors of advanced IAB were the age of >80 years, left atrial enlargement (left atrial diameter of >40 mm), and BMI of >25 kg/m 2 , which supports and extends the results of previous studies. A study by Bryce Alexander et al demonstrated BMI of >30 kg/m 2 , male sex, and increased age (per 10 years increase) (OR = 1.46, 95% CI: 1.14–1.88) were significant predictors of IAB in patients with carotid and coronary artery disease ( Alexander et al, 2018 ). The Atherosclerosis Risk in Communities (ARIC) study showed that age, male sex, BMI, and systolic blood pressure were all risk factors for advanced IAB development ( O'Neal et al, 2016b ).…”

Section: Discussionmentioning

confidence: 99%

Advanced Interatrial Block Predicts Recurrence of Atrial Fibrillation and Ischemic Stroke in Elderly Patients With Hypertension

et al. 2022

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Background: This study aimed to investigate whether advanced interatrial block (IAB) is a predictor of recurrent atrial fibrillation (AF) and/or ischemic stroke in elderly patients with AF and hypertension.Methods and objectives: Five hundred and sixteen elderly inpatients (mean age 85.53 ± 9.08 years; 5.43% women) with concurrent paroxysmal AF and hypertension were enrolled in this retrospective observational study. Data on comorbidity, medication, digital electrocardiograms (ECG), and outcomes were obtained from the medical records and follow-up examinations. IAB was classified as partial IAB or advanced IAB according to 12-lead surface ECG analysis on admission. Advanced IAB was defined as a maximum P wave duration of >120 ms with biphasic (±) morphology in leads II, Ⅲ, and aVF by two blinded investigators. The endpoints were recurrent AF and ischemic stroke.Results: We enrolled 120 patients (23.26%) with partial IAB and 187 (36.24%) with advanced IAB. The mean follow-up duration was 19 months. A total of 320 patients (62.02%) developed AF recurrence, and 31 (6.01%) experienced ischemic stroke. Significant predictors of advanced IAB in multivariate analysis were older age (>80 years), increased left atrial diameter (>40 mm), and being overweight (body mass index >25 kg/m2). In the multivariable comprehensive Cox regression analyses, partial IAB was associated with AF recurrence. Advanced IAB was an independent predictor of increased risk of AF recurrence and ischemic stroke.Conclusion: Both partial and advanced IAB are associated with AF recurrence in elderly patients with hypertension. Furthermore, advanced IAB is an independent predictor of ischemic stroke.

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“…Es importante mencionar que el patrón electrocardiográfico puede ser cambiante, coexistir con otras alteraciones del ritmo (en especial con FA) y/o la conducción, así como coexistir con alteraciones auriculares, en especial crecimiento y remodelación de la aurícula izquierda. El SB se asocia clínicamente, y relacionado a la FA y desincronización auriculoventricular, a evento vascular cerebral de tipo cardioembólico, por lo que en estos pacientes se debe realizar un protocolo diagnóstico que incluya estudio Holter, ecocardiograma y, cuando amerite, resonancia magnética nuclear (12)(13)(14)(15) .…”

Section: Discussionunclassified

Síndrome de Bayés en el perioperatorio

Carrillo-Esper

Carrillo-Córdova

2021

Revista Mexicana De Anestesiología

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RESUMEN.Los bloqueos auriculares se caracterizan por alteraciones en la conducción secundarias a un retardo o bloqueo en el haz de Bachmann. El Dr. Antonio Bayés de Luna fue uno de los primeros en describir de manera extensa esta entidad a partir de 1979, clasificándolo en inter-e intraauriculares. El bloqueo interauricular se caracteriza en el electrocardiograma (ECG) por onda P con duración mayor a 120 mseg y que presentan morfología bimodal, especialmente en las derivaciones DI, DII, aVL y en las derivaciones inferiores. Existen varios tipos y grados de bloqueo interauricular relacionados a la magnitud del deterioro de la conducción entre las aurículas. Este bloqueo se asocia con frecuencia a taquiarritmias, en especial fibrilación auricular. El manejo incluye antiarrítmicos, anticoagulantes y, en casos especiales, terapia de resincronización auricular. El objetivo de este trabajo es enfatizar en la importancia de la evaluación de la onda P y de los bloqueos interauriculares en el período perioperatorio.

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Interatrial block predicts atrial fibrillation in patients with carotid and coronary artery disease

Abstract: IAB is a predictor of new-onset AF in patients with carotid and coronary artery disease. Both carotid and coronary artery disease are associated with a higher prevalence of IAB.

Cited by 11 publications

References 22 publications

Evaluation of electrocardiographic P wave parameters in predicting long-term atrial fibrillation in patients with acute ischemic stroke

Evaluation of electrocardiographic P wave parameters in predicting long-term atrial fibrillation in patients with acute ischemic stroke

Advanced Interatrial Block Predicts Recurrence of Atrial Fibrillation and Ischemic Stroke in Elderly Patients With Hypertension

Síndrome de Bayés en el perioperatorio

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