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Interatrial block in hypertrophic cardiomyopathy: Associations with left atrial remodeling and adverse atrial

Leydimar Adel Anmad Shihadeh Musa1, Albert Teis2, Marta Sabate3

  • 1Department of Cardiology, Hospital Universitari Joan XXIII, Tarragona, Spain; Pere Virgili Health Research Institute (IISPV), Tarragona, Spain.

Heart Rhythm
|February 4, 2026
PubMed

Insights

Interatrial block (IAB) in hypertrophic cardiomyopathy (HCM) patients is linked to left atrial remodeling. This electrocardiographic finding independently predicts a higher risk of atrial fibrillation and stroke.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiovascular Imaging

Background:

  • Interatrial block (IAB) is associated with atrial fibrillation (AF) and stroke in general cardiovascular populations.
  • The relationship between IAB, left atrial (LA) remodeling, and outcomes in hypertrophic cardiomyopathy (HCM) is not well understood.

Purpose of the Study:

  • To determine the prevalence of IAB in HCM patients.
  • To explore the association between IAB and LA structural/functional changes.
  • To evaluate the prognostic significance of IAB for AF and stroke in HCM.

Main Methods:

  • A multicenter study of 259 HCM patients without prior AF or stroke.
  • IAB defined by P-wave duration >120 ms.
  • Cardiac MRI assessed LA morphology and function; follow-up for new-onset AF, TIA, or ischemic stroke.

Main Results:

  • IAB was identified in 10% of HCM patients.
  • IAB correlated with larger LA dimensions, higher LA volumes, impaired LA ejection fraction, and reduced LA reservoir and conduit strain.
  • IAB independently predicted a twofold increased risk of AF/stroke (HR 2.11) and new-onset AF (HR 2.10) during follow-up.

Conclusions:

  • IAB in HCM patients signifies advanced atrial cardiomyopathy with structural and functional LA impairments.
  • IAB serves as a valuable electrocardiographic marker for identifying HCM patients at increased risk of AF and stroke.
  • This finding supports using IAB for enhanced risk stratification in HCM.
Abstract

Keywords:
Atrial cardiomyopathyAtrial fibrillationCardiac magnetic resonanceElectrocardiographyHypertrophic cardiomyopathyInteratrial blockRisk stratificationStroke

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