Bayés’ syndrome: the association between interatrial block and supraventricular arrhythmias

Conde, Diego; Seoane, Leonardo; Gysel, Michael; Mitrione, Soledad; Luna, Antoni Bayés de; Baranchuk, Adrián

doi:10.1586/14779072.2015.1037283

Cited by 39 publications

(45 citation statements)

References 39 publications

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“…First, advanced IAB is likely a presentation of AP‐independent atrial electrophysiological abnormalities that remain after successful AP ablation. In support of this, advanced IAB was previously reported to reflect the underlying atrial substrate with atrial fibrosis and to be associated with the development of AF . Second, advanced IAB may play a role in initiating and maintaining reentry circuits by promoting the occurrence of unidirectional block, an important mechanism in the development of AF.…”

Section: Discussionmentioning

confidence: 66%

“…A prolonged P‐wave with biphasic (±) morphology in the inferior leads represents an even higher degree of IAB and has been referred to as advanced IAB . The appearance of advanced IAB is frequently associated with atrial tachyarrhythmias, and has been found to predict AF in multiple clinical scenarios . However, the role of advanced IAB in predicting the recurrence of AF after AP ablation in patients with WPW syndrome is unclear.…”

Section: Introductionmentioning

confidence: 99%

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Advanced interatrial block predicts recurrence of atrial fibrillation after accessory pathway ablation in patients with Wolff‐Parkinson‐White syndrome

Zhao

et al. 2019

Clinical Cardiology

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Background Paroxysmal atrial fibrillation (AF) frequently occurs in patients with Wolff‐Parkinson‐White (WPW) syndrome. Although successful ablation of the accessory pathway (AP) eliminates paroxysmal AF in some patients, in other patients it can recur. Hypothesis We investigated the clinical utility of advanced interatrial block (IAB) for predicting the risk of AF recurrence in patients with verified paroxysmal AF and WPW syndrome after successful AP ablation. Methods This retrospective study included 103 patients (70 men, 33 women; mean age, 44 ± 16 years) with WPW syndrome who had paroxysmal AF. A resting 12‐lead electrocardiogram was performed immediately after successful AP ablation to evaluate the presence of advanced IAB, which was defined as a P‐wave duration of >120 ms and biphasic [±] morphology in the inferior leads. Results During the mean follow‐up period of 30.9 ± 20.0 months (range, 2‐71 months), 16 patients (15.5%) developed AF recurrence. Patients with advanced IAB had significantly reduced event‐free survival from AF ( P < .001). Cox regression analysis with adjustment for the left atrial diameter and CHA 2 DS 2 ‐VASc score identified advanced IAB (hazard ratio, 9.18; 95% confidence interval [CI], 2.30‐36.72; P = .002) and age > 50 years (hazard ratio, 12.64; 95% CI, 1.33‐119.75; P = .027) as independent predictors of AF recurrence. Conclusions Advanced IAB was an independent predictor of AF recurrence after successful AP ablation in patients with WPW syndrome.

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Section: Discussionmentioning

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Advanced interatrial block predicts recurrence of atrial fibrillation after accessory pathway ablation in patients with Wolff‐Parkinson‐White syndrome

Zhao

et al. 2019

Clinical Cardiology

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“…Preoperative ECG and clinical data were extracted from electronic patient files. Preoperative surface ECGs were screened for the occurrence of interatrial block based on the Bayes criteria …”

Section: Methodsmentioning

confidence: 99%

Impact of Ischemic and Valvular Heart Disease on Atrial Excitation:A High‐Resolution Epicardial Mapping Study

Mouws

Lanters

Teuwen

et al. 2018

JAHA

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BackgroundThe influence of underlying heart disease or presence of atrial fibrillation (AF) on atrial excitation during sinus rhythm (SR) is unknown. We investigated atrial activation patterns and total activation times of the entire atrial epicardial surface during SR in patients with ischemic and/or valvular heart disease with or without AF.Methods and ResultsIntraoperative epicardial mapping (N=128/192 electrodes, interelectrode distances: 2 mm) of the right atrium, Bachmann's bundle (BB), left atrioventricular groove, and pulmonary vein area was performed during SR in 253 patients (186 male [74%], age 66±11 years) with ischemic heart disease (N=132, 52%) or ischemic valvular heart disease (N=121, 48%). As expected, SR origin was located at the superior intercaval region of the right atrium in 232 patients (92%). BB activation occurred via 1 wavefront from right‐to‐left (N=163, 64%), from the central part (N=18, 7%), or via multiple wavefronts (N=72, 28%). Left atrioventricular groove activation occurred via (1) BB: N=108, 43%; (2) pulmonary vein area: N=9, 3%; or (3) BB and pulmonary vein area: N=136, 54%; depending on which route had the shortest interatrial conduction time (P<0.001). Ischemic valvular heart disease patients more often had central BB activation and left atrioventricular groove activation via pulmonary vein area compared with ischemic heart disease patients (N=16 [13%] versus N=2 [2%]; P=0.009 and N=86 [71%] versus N=59 [45%]; P<0.001, respectively). Total activation times were longer in patients with AF (AF: 136±20 [92–186] ms; no AF: 114±17 [74–156] ms; P<0.001), because of prolongation of right atrium (P=0.018) and BB conduction times (P<0.001).ConclusionsAtrial excitation during SR is affected by underlying heart disease and AF, resulting in alternative routes for BB and left atrioventricular groove activation and prolongation of total activation times. Knowledge of atrial excitation patterns during SR and its electropathological variations, as demonstrated in this study, is essential to further unravel the pathogenesis of AF.

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“…The sample‐size estimation is based on the association between IAB and AF and the following assumptions: Incidence of AF in the nonexposed population. According to recent worldwide data, the incidence of new AF in the population age >70 years in Western Europe and North America, in a 2‐year follow‐up, is estimated to be approximately 4% (for individuals with a normal P‐wave duration and the clinical characteristics defined in the inclusion criteria) Effect size of the association between the presence of IAB and AF.…”

Section: Methodsmentioning

confidence: 99%

“…In 2012, a consensus paper defined the current ECG diagnostic criteria: partial IAB (P‐wave duration ≥120 ms) and advanced IAB (P‐wave duration ≥120 ms plus biphasic [plus/minus] morphology in inferior leads II, III, and aVF). The interest in this topic has increased in recent years, and a large number of studies recently have been published regarding the prevalence of IAB and its associations with the risk of AF, ischemic stroke, and cognitive decline . However, most studies have been performed retrospectively in the general population, where, even in the presence of IAB, the incidence of AF and stroke is low.…”

Section: Introductionmentioning

confidence: 99%

Rationale and design of the BAYES (Interatrial Block and Yearly Events) registry

Martínez‐Sellés

Baranchuk

Elosúa

et al. 2016

Clinical Cardiology

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The prevalence of interatrial block (IAB) is high in the elderly, particularly in those with heart disease. Despite this high prevalence-and the association of IAB with the risk of atrial fibrillation (AF), stroke, and cognitive decline-little information exists about the prognosis of older patients with IAB. P-wave duration and morphology are associated with risk of developing AF, stroke, and cognitive decline in elderly patients with structural heart disease. The aim of the Interatrial Block and Yearly Events (BAYES) registry is to assess the impact of IAB on the risk of AF and stroke during 3 years of follow-up. A series of 654 ambulatory patients age ≥70 years with heart disease from 35 centers will be included in 3 similar-size groups of patients. Group A: normal P-wave duration (<120 ms); Group B: partial IAB (P-wave duration ≥120 ms without biphasic [plus/minus] morphology in the inferior leads II, III, and aVF); and Group C: advanced IAB (P-wave duration ≥120 ms with biphasic [plus/minus] morphology in the inferior leads II, III, and aVF). Patients will be managed according to current recommendations. The 2 primary endpoints are defined as (1) AF duration >5 minutes and documented in any form of electrocardiographic recording; and (2) stroke. Results from this study might significantly improve the knowledge of IAB and its impact on the outcome of elderly patients with heart disease and could open the door to the use of anticoagulation therapy in some elderly patients with IAB.

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Bayés’ syndrome: the association between interatrial block and supraventricular arrhythmias

Cited by 39 publications

References 39 publications

Advanced interatrial block predicts recurrence of atrial fibrillation after accessory pathway ablation in patients with Wolff‐Parkinson‐White syndrome

Advanced interatrial block predicts recurrence of atrial fibrillation after accessory pathway ablation in patients with Wolff‐Parkinson‐White syndrome

Impact of Ischemic and Valvular Heart Disease on Atrial Excitation:A High‐Resolution Epicardial Mapping Study

Rationale and design of the BAYES (Interatrial Block and Yearly Events) registry

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