Interatrial Block to Guide the Thromboembolic Prevention Strategy: Should It be the Next Step?

Anticoagulation in patients at high risk of stroke without documented atrial fibrillation. Time for a paradigm shift?

“…It is necessary to emphasize that the vast majority of patients with A‐IAB have at the same time a CHA 2 DS 2 ‐VASc score ≥2 and therefore, if AF is documented, the patients would fulfil conventional indications for oral anticoagulation. Consequently, one could argue that given the association of A‐IAB with AF, there is a possibility that many strokes would be avoided if patients with high CHA 2 DS 2 ‐VASc score and A‐IAB, were treated with anticoagulation regardless of the documented evidence of AF (Chhabra & Gowdar, ; Hughes & Worrall, ; Martínez‐Sellés, Fernández Lozano, Baranchuk, Bayes‐Genis, & Bayés de Luna, ). Of course, the possible benefits derived from this hypothesis; need to be counter balanced with the possible side effects of anticoagulation.…”

Interatrial block as a predictor of atrial fibrillation in patients with ST‐segment elevation myocardial infarction

“…Advanced IAB (a‐IAB) presents biphasic morphology in the inferior leads (II, III, aVF) while partial IAB (p‐IAB) does not present a negative component in the inferior leads. Recently, several studies identified IAB as a reliable predictor for new onset of atrial fibrillation (AF), AF recurrences following pulmonary vein isolation and pharmacological cardioversion and increased risk of ischemic stroke …”

“…Recently, several studies identified IAB as a reliable predictor for new onset of atrial fibrillation (AF), [6][7][8] AF recurrences following pulmonary vein isolation 9 and pharmacological cardioversion 10 and increased risk of ischemic stroke. [11][12][13][14] Our aim in the present study was to investigate the prevalence of IAB in patients presenting with acute ST-segment elevation myocardial infarction (STEMI), its relation with specific culprit coronary artery lesion and its ability to predict new onset AF at 12 months follow-up.…”

Left Atrial Standstill and Interatrial Block

“…2 Bay es's syndrome is the association of A-IAB with supraventricular tachyarrhythmias, more specifically AF. [2][3][4] It is diagnosed when the P-wave duration is longer than 120 msec and there is a biphasic morphology in leads II, III, and aVF. Interatrial block may (or may not) be associated with LA enlargement, and represents LA electromechanical dysfunction.…”