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

Vanesa Bruña1, Jesús Velásquez-Rodríguez1, María Jesús Valero-Masa1

  • 1Department of Cardiology, Hospital General Universitario Gregorio Marañón, CIBERCV, Madrid, Spain.

Cardiology
|May 23, 2019
PubMed

Insights

Interatrial block (IAB) is present in about a quarter of patients after ST-elevation myocardial infarction (STEMI). Advanced IAB indicates a poor prognosis, primarily linked to patient age and other factors.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Internal Medicine

Background:

  • The prognostic significance of interatrial block (IAB) following acute ST-segment elevation myocardial infarction (STEMI) remains largely uncharacterized.
  • Understanding IAB's impact is crucial for risk stratification in STEMI survivors.

Purpose of the Study:

  • To investigate the prognostic implications of interatrial block (IAB) in patients post-acute ST-segment elevation myocardial infarction (STEMI).
  • To evaluate the association of IAB with long-term mortality, atrial fibrillation development, and stroke incidence.

Main Methods:

  • A registry study included 972 STEMI patients in sinus rhythm at discharge, with long-term follow-up (mean 49.6 months).
  • Patients were categorized based on P wave duration and morphology: normal (<120 ms), partial IAB (pIAB) (≥120 ms, inferior leads positive), and advanced IAB (aIAB) (≥120 ms, inferior leads biphasic).

Main Results:

  • Interatrial block was identified in 27.2% of patients (21.3% pIAB, 5.9% aIAB).
  • Patients with advanced IAB were older and had higher rates of hypertension and all-cause mortality compared to those with normal P waves or partial IAB.
  • Multivariable analysis did not reveal an independent association between IAB and adverse prognosis.

Conclusions:

  • Interatrial block is a common finding in STEMI patients discharged in sinus rhythm.
  • While advanced IAB is associated with poorer outcomes, this appears to be confounded by age and other comorbidities.
Abstract

Keywords:
Atrial fibrillationInteratrial blockMyocardial infarctionPrognostic valueStroke

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