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Advanced Interatrial Block Predicts Recurrence of Atrial Fibrillation and Ischemic Stroke in Elderly Patients With

Haijun Wang1, Lili Cai2, Yan Guo1

  • 1Department of Cardiology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China.

Frontiers in Physiology
|July 5, 2022
PubMed

Insights

Advanced interatrial block (IAB) predicts recurrent atrial fibrillation (AF) and ischemic stroke in elderly patients with hypertension. This finding highlights IAB as a crucial indicator for cardiovascular risk in this population.

Area of Science:

  • Cardiology
  • Geriatrics
  • Electrocardiography

Background:

  • Elderly patients with atrial fibrillation (AF) and hypertension are at high risk for adverse cardiovascular events.
  • Interatrial block (IAB) is an electrocardiographic finding that may indicate underlying atrial pathology.
  • The predictive value of advanced IAB for recurrent AF and ischemic stroke in this population remains unclear.

Purpose of the Study:

  • To investigate if advanced interatrial block (IAB) predicts recurrent atrial fibrillation (AF) and ischemic stroke in elderly patients with both AF and hypertension.
  • To determine the association between different classifications of IAB and cardiovascular outcomes.

Main Methods:

  • Retrospective observational study of 516 elderly inpatients with paroxysmal AF and hypertension.
  • Classification of IAB into partial and advanced based on 12-lead ECG criteria (P wave duration >120 ms with biphasic morphology in inferior leads for advanced IAB).
  • Follow-up for a mean duration of 19 months to record outcomes of recurrent AF and ischemic stroke.

Main Results:

  • 120 patients (23.26%) had partial IAB and 187 (36.24%) had advanced IAB.
  • AF recurrence occurred in 62.02% and ischemic stroke in 6.01% of patients.
  • Advanced IAB was an independent predictor of both recurrent AF and ischemic stroke, while partial IAB was associated with AF recurrence.

Conclusions:

  • Both partial and advanced IAB are linked to AF recurrence in elderly hypertensive patients.
  • Advanced IAB independently predicts an increased risk of ischemic stroke in this patient group.
  • IAB classification on ECG may aid in risk stratification for elderly patients with AF and hypertension.

Keywords:
atrial fibrillationelderlyhypertensioninteratrial blockstroke

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