Interatrial block and atrial arrhythmias in centenarians: Prevalence, associations, and clinical implications

Martínez‐Sellés, Manuel; Roessel, Albert Massó-van; Álvarez‐García, Jesús; Villa, Bernardo García de la; Cruz-Jentoft, Alfonso J.; Vidán, María Teresa; Díaz, Javier López; Félix-Redondo, Francisco Javier; Guerrero, Juan Manuel Durán; Bayés‐Genís, Antoni; Luna, Antonio

doi:10.1016/j.hrthm.2015.10.034

Cited by 94 publications

(74 citation statements)

References 29 publications

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“…It is well-known that the prevalence of IAB increases with age, especially in the case of aIAB [2]. In our study, patients with a normal P wave duration and those with pIAB had a similar mean age, but the mean age in patients with aIAB was 11 years higher.…”

Section: Discussionsupporting

confidence: 46%

“…Interatrial block (IAB) is a conduction delay between the right atrium and the left atrium associated with atrial fibrosis [1], frequently seen in the elderly [2] and in patients with heart disease [3]. Although the conduction delay could be in several locations around the atrium, in the case of advanced IAB (aIAB), the upper interatrial zone around the Bachmann bundle is usually the one affected.…”

Section: Introductionmentioning

confidence: 99%

“…In recent years, this conduction disorder has become important due to its demonstrated clinical relevance, association with atrial fibrillation (AF), ischemic stroke, cognitive impairment, and prognosis [2, 5-8]. Even, in some patients with stable coronary disease, exercise-induced prolongation of the P wave has been described [9].…”

Section: Introductionmentioning

confidence: 99%

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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: 46%

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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“…Studies have shown that Bayes syndrome is a predictor of AF, ischemic stroke risk particularly of cardioembolic subtype, silent cerebrovascular disease, and vascular cognitive impairment. 67, 68 …”

Section: Biomarkers Of Atrial Cardiopathymentioning

confidence: 99%

Atrial cardiopathy: a mechanism of cryptogenic stroke

Yaghi

Kamel

Elkind

2017

Expert Review of Cardiovascular Therapy

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Introduction Cryptogenic stroke accounts for approximately 30% of all ischemic strokes. Recently, atrial cardiopathy diagnosed by the presence of one of its serum, imaging, or electrocardiogram biomarkers has been shown to be associated with ischemic stroke, particularly of embolic subtypes. Areas covered This paper aims to summarize data on occult atrial fibrillation and stroke, provide an overview on mechanisms, such as inflammation and fibrosis, of stroke in atrial cardiopathy, critically review data on biomarkers of atrial cardiopathy and their association with stroke, and suggest therapeutic implications, including directions for future research. Expert commentary Atrial cardiopathy may constitute one of the mechanisms in cryptogenic stroke, and patients with evidence of atrial cardiopathy constitute a group of patients in whom clinical trials are warranted to test anticoagulation versus antiplatelet therapy to reduce stroke recurrence risk. In addition, more studies are needed to determine the degree of overlap between these atrial cardiopathy biomarkers and which one is more useful in predicting the risk of stroke and response to anticoagulation therapy.

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“…In a clinical study conducted in centenarians, the rate of dementia was 48% in subjects with a normal P wave, 60% in those with partial IAB, and 81% in those with advanced IAB and 90% in those with atrial fibrillation[40]. …”

Section: A New Risk Factor For Cerebral Infarct and Vascular Dementiamentioning

confidence: 99%

Bayés syndrome and acute cardioembolic ischemic stroke

Arboix

Martí

Dorison

et al. 2017

WJCC

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Bayés syndrome is an under-recognized clinical condition characterized by advanced interatrial block. Bayés syndrome is a subclinical disease that manifests electrocardiographically as a prolonged P wave duration > 120 ms with biphasic morphology ± in the inferior leads. The clinical relevance of Bayés syndrome lies in the fact that is a clear arrhythmological syndrome and has a strong association with supraventricular arrhythmias, particularly atypical atrial flutter and atrial fibrillation. Likewise, Bayés syndrome has been recently identified as a novel risk factor for non-lacunar cardioembolic ischemic stroke and vascular dementia. Advanced interatrial block can be a risk for embolic stroke due to its known sequelae of left atrial dilation, left atrial electromechanical dysfunction or atrial tachyarrhythmia (paroxysmal or persistent atrial fibrillation), conditions predisposing to thromboembolism. Bayés syndrome may be responsible for some of the unexplained ischemic strokes and shall be considered and investigated as a possible cause for cryptogenetic stroke. In summary, Bayés syndrome is a poorly recognized cardiac rhythm disorder with important cardiologic and neurologic implications.

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Interatrial block and atrial arrhythmias in centenarians: Prevalence, associations, and clinical implications

Cited by 94 publications

References 29 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

Atrial cardiopathy: a mechanism of cryptogenic stroke

Bayés syndrome and acute cardioembolic ischemic stroke

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