Advanced interatrial block: An electrocardiographic marker for stroke recurrence.

Area of Science:

• Cardiology
• Neurology
• Electrocardiography

Background:

• Interatrial block (IAB) is associated with atrial tachyarrhythmias and may be a stroke risk factor.
• Predicting stroke recurrence is crucial for patient management and secondary prevention strategies.

Purpose of the Study:

• To determine if the presence of interatrial block (IAB) can predict stroke recurrence in patients with a history of stroke.
• To investigate the association between IAB and the incidence of atrial tachyarrhythmias post-stroke.

Main Methods:

• Retrospective analysis of 149 patients discharged after stroke treatment in 2011 (excluding cardioembolic/lacunar).
• ECG recordings were analyzed to identify partial (P-wave duration ≥120 ms) and advanced IAB (P-wave duration ≥120 ms with biphasic morphology in inferior leads).
• Primary endpoint: stroke recurrence; Secondary endpoint: atrial tachyarrhythmias. Median follow-up was 3.96 years.

Main Results:

• Of 149 patients, 27 (18%) experienced stroke recurrence and 20 (13%) developed atrial tachyarrhythmias.
• Multivariate analysis revealed advanced IAB as a significant predictor of stroke recurrence (HR: 2.3, p=0.043).
• Diabetes was also significantly associated with stroke recurrence (HR: 2.5, p=0.018).

Conclusions:

• Advanced interatrial block is a significant predictor of stroke recurrence in patients with a prior stroke episode.
• The findings suggest that IAB, particularly advanced IAB, should be considered in stroke risk assessment.
• Further research is warranted to explore potential interventions targeting IAB to prevent stroke recurrence.