Exercise-Induced Improvement in Atrial Depolarization Abnormality in a Patient after Treatment with Beta-Adrenergic Blockers

Abstract

Abnormal atrial depolarization, characterized by P waves ≧110 ms on the electrocardiogram, can manifest as partial or advanced interatrial conduction delay or interatrial block (IAB). Progression from partial to advanced IAB has been shown to be altered by the use of angiotensin-converting enzyme inhibitors and β-adrenergic blockers. We previously reported that advanced IAB, denoted by biphasic P waves in leads II, II and aVF, can revert intermittently to its partial counterpart. However, potential factors that could induce such resolution remain unknown. We present the first known case of resolution of advanced IAB to partial IAB occurring during graded exercise, following treatment with a β-adrenergic blocker. Only continued study of these and other novel factors will help us understand the exact pathophysiology of both, partial and advanced IAB.

Interatrial Block in the Modern Era

“…Ariyarajah et al . had reported spontaneous regression from advanced to partial IAB and resolution of advanced IAB to partial IAB with graded exercise during treatment with a β-adrenergic blocker [71]. …”

Interatrial block: there is an occasion to reflect

“…на фоне замедления эпизодически происходит блокада проведения либо чередование нормального МП-проведения и блокады 1 или 3 ст., например после экстрасистолии [23]. При прогрессировании основного заболевания с развитием дилатации ЛП может происходить ухудшение МП-проведения, однако описаны случаи уменьшения блокады МП-проведения с 3 до 1 ст., например при лечении β-адреноблокаторами [24].…”