Atrioventricular block can be used as a risk predictor of clinical atrial fibrillation

Abstract

Background Atrial fibrillation (AF) is the most common cardiac arrhythmia, with its incidence making up nearly one‐third of all hospital admissions. Atrioventricular block (AVB) is a conduction abnormality along the atrioventricular node or the His‐Purkinje system. The relationship between atrioventricular conduction block and AF is controversial. Hypothesis This study is designed to observe whether there is a correlation between AVB and AF, and which type of AVB has the most obvious correlation with AF. Methods This study retrospectively reviewed 1345 patients. We classified the AVB according to the AVB classification criteria. One hundred and two patients were excluded, and the final total sample size was 1243 patients, including 679 patients in the AF group (378, 55.7% males) and 564 patients in the non‐AF group (287, 50.8% males). AF group and non‐AF group were compared to observe the relationship between AVB and AF. Results The I AVB have a relative statistical risk of 1.927 (95% confidence interval [CI]: 1.160‐3.203, P < 0.05) with the occurrence of AF. II AVB occupied the largest proportion, accounting for 67 cases (9.87%), and the statistical risk of II AVB in AF is 16.845 (95% CI: 6.099‐46.524, P < 0.000). III AVB has a comparative statistical risk of 17.599 (95% CI: 4.212‐73.541, P < 0.000). Conclusions The three types of AVB in the AF group were significantly higher than that in the non‐AF group. II AVB has the highest incidence rate compared with other types of AVB in the AF group. AVB can be used as a risk factor for AF occurrence.

Association between routine biomarkers and atrial fibrillation in patients undergoing implantation of a dual‐chamber pacemaker

“…Regarding the association of second‐ or third‐degree atrioventricular block and AF, the data are sparse. Recently, in a retrospective analysis, Zhao et al showed that all three main types of atrioventricular block are associated with AF 5 . Moreover, in a small study of 81 patients over 70 years old, with no AF history, who were implanted a pacemaker owing to complete heart block, 65% developed AHRE with duration >5 min after 18 months of follow‐up 6 .…”

“…3,4 In fact, tachy-brady syndrome is a very frequent manifestation of SND. On the other hand, the evidence linking second-or third-degree atrioventricular block with AF is less robust, 5 while atrial high-rate episodes (AHRE) and AF observed after the implantation of a pacemaker in these patients may be associated with new-onset heart failure/pacing-induced cardiomyopathy. 6,7 The pathophysiology of atrial remodeling is very complex, and the molecular pathways implicated in the initiation and perpetuation of AF show a high diversity and variability across different underlying substrates.…”

Cardiac Stimulation in the Third Millennium: Where Do We Head from Here?

“…Fusion between A3 and A4 may occur during sinus tachycardia; thus, limiting rate increase and exercise tolerance. Body movement can interfere with A4 sensing, as well as frequent PVCs [98]. Rate smoothing can mitigate transient atrial undersensing: assuming a regular atrial activation, pacing occurs for a brief period also when A4 signal is hampered.…”

Whole-Exome Sequencing Identifies a Novel TRPM4 Mutation in a Chinese Family with Atrioventricular Block

“…Inherited progressive cardiac conduction disease (PCCD) is defined as an abnormal progressive cardiac conduction disorder [1], in which atrioventricular block (AVB) is characteristic by the presence of heart conduction block between atria and ventricle on 12-lead electrocardiogram (ECG). This abnormality of cardiac conduction will elevate the risk of sudden cardiac death, which will become a heavy burden for both family and society [2][3][4]. AVB can be classified into three tiers according to the extension degree and ECG.…”