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Advanced interatrial block: An electrocardiographic marker for stroke recurrence

Camila S García-Talavera1, Álvaro Aceña2, Alberto Andrés López3

  • 1Department of Cardiology, IIS-Fundación Jiménez Díaz, Madrid, Spain.

Journal of Electrocardiology
|August 18, 2019
PubMed

Insights

Advanced interatrial block (IAB) predicts stroke recurrence in patients with a prior stroke. This finding highlights IAB as a significant risk factor for recurrent stroke, suggesting potential for targeted interventions.

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.

Keywords:
Atrial tachyarrhythmiasInteratrial blockStroke

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