Atypical advanced interatrial blocks: Definition and electrocardiographic recognition
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Updated: Feb 1, 2026

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System
Published on: April 11, 2025
Antoni Bayés de Luna1, Luis Alberto Escobar-Robledo1, David Aristizabal1
1Cardiovascular Research Foundation, Cardiovascular ICCC-Program, Research Institute Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain.
Abstract:
The diagnosis of advanced interatrial block (A-IAB) is done by surface ECG analysis when the P-wave ≥120 ms with biphasic (±) morphology in leads II, III and aVF. In this brief communication, we advance a new concept involving atypical patterns of A-IAB due to changes about the morphology or duration of the P-wave. It remains to be determined its real prevalence in different clinical scenarios, and whether these atypical ECG patterns should be considered as predictors of atrial fibrillation/stroke.
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