The prevalence and prognostic significance of interatrial block in the general population

Abstract

Introduction Partial and advanced interatrial block (IAB) in the ECG represents inter-atrial conduction delay. IAB is associated with atrial fibrillation (AF) and stroke in the general population. Material and methodsA representative sample of Finnish subjects (n=6 354) aged over 30 years (mean 52.2 years, SD 14.6) underwent a health examination including a 12-lead ECG. Five different IAB groups based on automatic measurements were compared to normal P waves using multivariate-adjusted Cox proportional hazard model. Follow-up lasted up to 15 years. ResultsThe prevalence of advanced and partial IAB was 1.0% and 9.7%, respectively. In the multivariate model, both advanced (hazard ratio [HR] 1.63 [95% CI 1.00 -2.65]) and partial IAB (HR 1.39 [1.09 -1.77]) were associated with increased risk of AF. Advanced IAB was associated with increased risk of stroke or transient ischemic attack (TIA) independently of associated AF ). Partial IAB was also associated with increased risk of being diagnosed with coronary heart disease ).Discussion IAB is a rather frequent finding in the general population. IAB is a risk factor for AF and is associated with an increased risk of stroke or TIA independently of associated AF. Key messages1. Both partial and advanced interatrial block are associated with increased risk of atrial fibrillation in the general population.2. Advanced interatrial block is an independent risk factor for stroke and transient ischemic attack.3. The clinical significance of interatrial block is dependent on the subtype classification.

Advanced interatrial block predicts ineffective cardioversion of atrial fibrillation: a FinCV2 cohort study

“…Our study reinforced the association to AF given the 4-fold increase in ineffective CV odds ratio. Furthermore, AIAB is also strongly associated with other cardiovascular conditions such as hypertension and stroke [17][18][19]21].…”

Ischemic stroke in a patient with interatrial block: Is it only a coincidence or a clear relationship?

“…Moreover, advanced IAB (aIAB) have been described to predict occurrence of new onset and recurrent AF [2]. The prevalence of aIAB and partial IAB is 1% and 9.7% respectively in the general population and they are both associated with increased risk of AF [7]. Its prevalence increases with age, reaching a prevalence of 26% (aIAB) and 20,1% (partial IAB) in subjects aged >100 years [5].…”

Cerebral Embolism Beyond Atrial Fibrillation: Interatrial Block

“…The prevalence of advanced and partial IAB is 1% and 9.7% respectively in the general population, and they are both associated with increased risk of AF [18]. Its prevalence increases with age, reaching a prevalence of 26% (advanced IAB) and 20.1% (partial IAB) in subjects aged ≥100 years [15].…”

“…In the case of advanced IAB, the association seems to be very similar. In the study Scientific Characterization of the Centennial Heart-Caracterización Científica del Corazón del Centenario (4C) [18], the prevalence of dementia increased progressively from normal P-wave, partial IAB, advanced IAB, and AF ( Figure 4). This independent association is probably mainly due to silent cerebral infarctions, although other factors such as chronic cerebral hypoperfusion may also play a role.…”