Prevalence of Interatrial Block in a General Population of Elderly People

Ninios, Ilias; Pliakos, Christodoulos; Ninios, Vlasios; Karvounis, Haralampos; Louridas, George

doi:10.1111/j.1542-474x.2007.00178.x

Cited by 13 publications

(15 citation statements)

References 12 publications

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“…Hypertension is another cardiovascular condition known to increase the risk of IAB [20]. This agrees with our findings for the prevalence of hypertension, which ranged from 49% in patients with normal P wave to 70% in those with aIAB.…”

Section: Discussionsupporting

confidence: 82%

Prognostic of Interatrial Block after an Acute ST-Segment Elevation Myocardial Infarction

et al. 2019

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Background: The influence of interatrial block (IAB) in the prognosis after an acute ST-segment elevation myocardial infarction (STEMI) is unknown. Objectives: To assess the prognostic impact of IAB after an acute STEMI regarding long-term mortality, development of atrial fibrillation, and stroke. Methods: Registry of 972 consecutive patients with STEMI and sinus rhythm at discharge, with a long-term follow-up (49.6 ± 24.9 months). P wave duration was analyzed using digital calipers, and patients were divided into three groups: normal P wave duration (<120 ms), partial IAB (pIAB) (P wave ≥120 ms and positive in inferior leads), and advanced IAB (aIAB) (P wave ≥120 ms plus biphasic [positive/negative] morphology in inferior leads). Results: Mean age was 62.6 ± 13.5 years. A total of 708 patients had normal P wave (72.8%), 207 pIAB (21.3%), and 57 aIAB (5.9%). Patients with aIAB were older (mean age 73 years) than the rest (62 years in the other two groups, p < 0.001). They also had a higher rate of hypertension (70 vs. 55% in pIAB and 49% in normal P wave, p = 0.006) and higher all-cause mortality (26.3 vs. 12.6% in pIAB and 10.3% in normal P wave, p = 0.001). However, multivariable analysis did not show an independent association between IAB and prognosis. Conclusion: About a quarter of patients discharged in sinus rhythm after an acute STEMI have IAB. Patients with aIAB have a poor prognosis, although this is explained mainly by the association of aIAB with age and other variables.

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Section: Discussionsupporting

confidence: 82%

Prognostic of Interatrial Block after an Acute ST-Segment Elevation Myocardial Infarction

et al. 2019

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“…The prevalence of P wave duration ≥110 msec has been estimated as high as 41%,20 and ≥120 msec as high as 47%21 in hospitalized samples prompting the description of this finding as “pandemic” 22. A community-based sample of individuals ≥65 years identified 400 of 678 (59%) subjects as having a P wave duration ≥110 msec 23. The prevalence among men and women was similar (58.5% and 59.4%, respectively).…”

Section: Distribution Of P Wave Indices Reported In the Literaturementioning

confidence: 99%

“…However, because most prior studies have not adjusted for the increases in risk factors and disease that occur with advancing age, it is uncertain whether aging per se increases P wave indices. Men and women in an older population (≥ 65 years) have been shown to have equivalent prevalence of P wave duration ≥110 msec 23. Similarly, ethnic/racial differences in P wave indices have been understudied.…”

Section: Clinical Correlates Associated With P Wave Dispersionmentioning

confidence: 99%

P Wave Indices

Magnani

Williamson

Ellinor

et al. 2009

Circ: Arrhythmia and Electrophysiology

106

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O ur review describes the current field of P wave indices. We report the methodology for determining P wave indices. We also describe the strengths and limitations of the current literature on the clinical correlates and prognosis of P wave indices. We suggest future clinical and research directions for P wave indices.The P wave indices of maximum duration and dispersion have received increasing attention and have been examined in a broad range of clinical settings. The ECG, as a vectorcardiogram, 1 quantifies the magnitude and direction of electric propagation and depolarization. Insults such as chronically elevated atrial pressure, ischemia, and metabolic stress lead to atrial remodeling marked by inflammation, fibrosis and poor cellular coupling. The electrophysiological result is slowed conduction with inhomogeneous recovery, defining a substrate for atrial fibrillation (AF). 2 Investigators hypothesize that P wave prolongation is an intermediate step in the accumulation of insults ultimately leading to AF. Thus, initial studies sought to demonstrate significant differences between samples with a history of AF and healthy referents, arguing that prolonged P wave duration and dispersion predict recurrent AF. Further studies have used P wave indices to compare multiple samples with and without cardiac diseases. The most recent iteration of studies has extended use of P wave indices beyond cardiac pathology to distinguish a variety of disease entities and comparison groups; the wide array of disease samples studied is listed in Table 1. Given such broad clinical applications, automated reporting of the P wave duration in electrocardiographic measurement for screening purposes has been advocated. 41 The variety of studies has resulted in varying methodologies and yielded conflicting results. Many areas in P wave indices research remain uncertain, including their clinical correlates and distribution in the community, and the extent to which P wave indices are associated with AF, predict its occurrence, are heritable phenotypes, or serve as biomarkers of other cardiovascular insults. The present review was undertaken to assess the current evidence for use of P wave indices with attention toward study design, strengths, and remaining questions surrounding their clinical application. Literature Search MethodsWe conducted a literature search of PubMed and OVID databases to identify articles published from January 1985 to December 2007. We searched using the Medical Subject Headings and key words of P wave dispersion, P wave indices, dispersion, AF, and ECG, both separately and together with predict and prediction. We reviewed reference lists of retrieved articles to identify additional publications for inclusion. Because of the volume of research in this area and the duplicative nature of the field's research, we excluded studies with less than 100 subjects unless they described a novel clinical application of P wave indices. Studies were described as cohort, case control, or cross-sectional. Case reports, scientific...

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“…Quality control assessments have been limited and have included variability around the mean intra- and interobserver differences;12 coefficients of variation;2;18;23 and the interobserver Kappa statistics 8. Community and hospital-based surveys also have shown wide variability in the prevalence of P wave prolongation and dispersion 24-27. Measurements of P wave dispersion in cohorts described as normal have ranged from 2828 to 52 msec 29.…”

mentioning

confidence: 99%

P‐Wave Indices, Distribution and Quality Control Assessment (from the Framingham Heart Study)

Magnani

Mazzini

Sullivan³

et al. 2010

Noninvasive Electrocardiol

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Prevalence of Interatrial Block in a General Population of Elderly People

Abstract: The surprisingly large prevalence of the IAB in the general older population emphasizes the importance of the early recognition of this abnormality from the surface 12-lead electrocardiogram.

Cited by 13 publications

References 12 publications

Prognostic of Interatrial Block after an Acute ST-Segment Elevation Myocardial Infarction

Prognostic of Interatrial Block after an Acute ST-Segment Elevation Myocardial Infarction

P Wave Indices

P‐Wave Indices, Distribution and Quality Control Assessment (from the Framingham Heart Study)

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