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Antonio Bayes De Luna - One of the best experts on this subject based on the ideXlab platform.
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Second-degree Interatrial Block: A case series.
Journal of Electrocardiology, 2019Co-Authors: Chang Nancy Wang, Antonio Bayes De Luna, Juan Manzzardo, Damián Longo, Rachel E. Green, Adrian BaranchukAbstract:Abstract Advanced Interatrial Block (IAB) (P-wave ≥120 ms and biphasic P-wave in leads II, III and aVF) is a prevalent ECG pattern frequently associated with supraventricular arrhythmias and stroke, especially in patients with structural heart disease. Intermittent IAB is a much more poorly defined electrocardiographic entity with uncertain clinical significance. In this case series, we review and analyze eight cases of second degree intermittent IAB. In six cases, there is normalization of advanced IAB after a premature supraventricular or ventricular contraction, suggesting a functional Block that temporarily recovers post extra-systolic pause. Recognition of intermittent IAB (second degree) may help further characterize the prognostic and clinical implications of this ECG pattern.
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Second-degree Interatrial Block: Brief review and concept.
Annals of Noninvasive Electrocardiology, 2018Co-Authors: Antonio Bayes De Luna, Adrian Baranchuk, Manuel Martínez-sellés, Roberto Elosua, César Niño Pulido, A. Bayes-genis, Marcelo V. ElizariAbstract:The advanced Interatrial Block (A-IAB) (P ≥ 120 ms plus ± pattern in II, III and aVF) corresponds at atrial level, to right or left advanced bundle branch Block at ventricular level, and it is well known that these patterns may be seen transiently in relation to taquicardia or bradycardia (tachycardia or bradycardia dependent right or left bundle branch Block). We present for the first time, the same phenomenon at atrial level. In one case, the A-IAB appears in relation to tachycardization and in the other disappears during a pause induced by ventricular premature complex.
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Interatrial Block and atrial remodeling assessed using speckle tracking echocardiography.
BMC Cardiovascular Disorders, 2018Co-Authors: Juan Lacalzada-almeida, Roberto Elosua, María Manuela Izquierdo-gómez, Carima Belleyo-belkasem, Patricia Barrio-martínez, Javier García-niebla, Alejandro Jiménez-sosa, Luis Alberto Escobar-robledo, Antonio Bayes De LunaAbstract:To evaluate the possibility of left atrial (LA) remodeling using speckle tracking echocardiography (STE) in patients with Interatrial Block (IAB). We performed a cross-sectional study with three groups of patients: 56 without IAB, 21 with partial IAB (pIAB), and 22 with advanced IAB (aIAB). Transthoracic echocardiographic (TTE) STE was performed and clinical and echocardiographic findings were analyzed. TTE showed higher LA volume/body surface area in the patients with IAB. With STE, the absolute value of strain rate during atrial booster pump function (SRa) and early reservoir period (SRs) decreased in the pIAB group and even more in the aIAB group, compared to the group without IAB. The independent variables were the echocardiographic measures of LA size and function. After adjusting for confounders, both multiple linear regression and multivariate multinomial regression showed good correlation with dependent variables: longer P-wave duration on electrocardiography and with the type of IAB, respectively. SRa (p
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Interatrial Block and atrial remodeling assessed using speckle tracking echocardiography
BMC Cardiovascular Disorders, 2018Co-Authors: Juan Lacalzadaalmeida, Roberto Elosua, Maria Manuela Izquierdogomez, Carima Belleyobelkasem, Patricia Barriomartinez, Javier Garcianiebla, Alejandro Jimenezsosa, Luis Alberto Escobarrobledo, Antonio Bayes De LunaAbstract:To evaluate the possibility of left atrial (LA) remodeling using speckle tracking echocardiography (STE) in patients with Interatrial Block (IAB). We performed a cross-sectional study with three groups of patients: 56 without IAB, 21 with partial IAB (pIAB), and 22 with advanced IAB (aIAB). Transthoracic echocardiographic (TTE) STE was performed and clinical and echocardiographic findings were analyzed. TTE showed higher LA volume/body surface area in the patients with IAB. With STE, the absolute value of strain rate during atrial booster pump function (SRa) and early reservoir period (SRs) decreased in the pIAB group and even more in the aIAB group, compared to the group without IAB. The independent variables were the echocardiographic measures of LA size and function. After adjusting for confounders, both multiple linear regression and multivariate multinomial regression showed good correlation with dependent variables: longer P-wave duration on electrocardiography and with the type of IAB, respectively. SRa (p < 0.001), SRs (p < 0.001), and maximal peak LA longitudinal strain in the reservoir period (p = 0.009) were independently associated with P-wave duration. SRa was also associated with the presence of pIAB (OR = 11.5; 95% confidence interval (CI): 2.7–49.0; p = 0.001) and aIAB, (OR = 98.2; 95% CI: 16–120.4; p < 0.001) and SRs was associated with pIAB (OR: 0.03; CI: 0.003–0.29; p = 0.003) and with aIAB (OR: 0.008; CI: 0.001–0.12; p = 0.004). IAB correlates directly with structural remodeling and a decrease in the absolute value of LA SRa and SRs determined using STE.
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Advanced Interatrial Block and ischemic stroke: The Atherosclerosis Risk In Communities StudyAuthor Response
Neurology, 2016Co-Authors: Manuel Martínez-sellés, Antonio Bayes De Luna, Adrian Baranchuk, Wesley T. O'neal, Roberto Elosua, Hooman Kamel, Zhu-ming Zhang, Lin Y. Chen, Alvaro Alonso, Elsayed Z. SolimanAbstract:Editors' Note: In Writ e Click this week, Drs. Martinez-Selles et al. ask whether in “Advanced Interatrial Block and ischemic stroke: The Atherosclerosis Risk in Communities Study” an association was seen between advanced Interatrial Block and dementia. Authors O'Neal et al. respond that an analysis of this question is forthcoming. Dr. Chang brings his …
Manuel Martínez-sellés - One of the best experts on this subject based on the ideXlab platform.
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Cerebral Embolism Beyond Atrial Fibrillation: Interatrial Block
Clinical Management Issues, 2020Co-Authors: Helena Martínez-sellés, Ana Ayesta, Manuel Martínez-sellésAbstract:This paper is devoted to conditions that imply a risk for cerebral embolism beyond atrial fibrillation (AF). We focus on advanced Interatrial Block (IAB) and its relationship with stroke in elderly patients with no documented arrhythmias. Advanced IAB is manifested in the surface electrocardiogram (ECG) as a P-wave duration >120 ms plus biphasic morphology (positive and negative deflection) in leads II, III, and aVF. Several data suggest that AF is not necessarily the leading cause of stroke, but rather a risk factor. In fact, a high stroke risk has been described even in the absence of AF in patients with high CHA 2 DS 2 VASc-score (Congestive Heart failure, hypertension, Age ≥75 years [doubled], Diabetes, Stroke [doubled], Vascular disease, Age 65-74 years, Sex category [female sex]). Moreover, excessive atrial ectopy and short atrial runs also increase stroke risk. Some of the previously mentioned stroke risk factors in patients without documented arrhythmias might be combined to determine thrombotic risk. That risk is particularly high in elderly patients with advanced IAB, structural heart disease, CHA 2 DS 2 -VASc score ≥3, and frequent ambient atrial arrhythmias. Systematic screening for advanced IAB in elderly patients can be performed with a simple surface ECG. Advanced IAB is a risk marker of stroke.
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Interatrial Block and cognitive impairment in the BAYES prospective registry.
International Journal of Cardiology, 2020Co-Authors: Manuel Martínez-sellés, Adrian Baranchuk, Antoni Bayes-genis, M. Esther Martínez-larrú, Martin Ibarrola, Alba Santos, Pablo Díez-villanueva, Antonio Bayés-de-luna, Roberto ElosuaAbstract:Abstract Background An association between Interatrial Block (IAB) (P wave duration ≥120 ms) and dementia has been suggested. Our objective was to assess the association of IAB with cognitive impairment (CI). Methods The prospective BAYES registry included 552 patients ≥70 years with structural heart disease without documented atrial fibrillation. Cognitive ability was assessed at baseline and every 6 months with the Pfeiffer test. The median follow-up was 22 months. Results Thirty patients (5.4%) had baseline CI, 20 patients with mild CI and 10 with moderate CI. Compared to patients without CI, patients with CI had higher mean age (80.4 ± 6.5 vs. 76.8 ± 5.4 years) and higher prevalence of advanced IAB (with biphasic P-wave ± in inferior leads) (14 [46.7%] vs. 122 [23.4%], p Conclusion In patients aged 70 years or more with structural heart disease who are in sinus rhythm advanced IAB is associated with baseline CI. There is also an association of partial and advanced IAB with CI during follow-up.
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Interatrial Block can occur in the absence of left atrial enlargement: New experimental model.
Pacing and Clinical Electrophysiology, 2020Co-Authors: Jose M. Guerra, Adrian Baranchuk, Antoni Bayés De Luna, Manuel Martínez-sellés, Gemma Vilahur, José Angel Cabrera, Guiomar Mendieta, Damián Sánchez-quintanaAbstract:We present the surface electrocardiogram of an open-chest anesthetized healthy adult swine after direct application of ice at the transversus sinus of the pericardium where the Bachmann's region is located. Gradual and transient Interatrial Block (IAB) in the absence of structural atrial disease is described. This new experimental model demonstrated that IAB is an independent entity from left atrial enlargement.
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Relation of Advanced Interatrial Block to Risk of Atrial Fibrillation and Stroke
American Journal of Cardiology, 2020Co-Authors: Antoni Bayés-de-luna, Adrian Baranchuk, Manuel Martínez-sellés, Roberto Elosua, Guiomar Mendieta, Antoni Bayes-genis, Günter BreithardtAbstract:Advanced Interatrial Block (A-IAB) has been associated to atrial fibrillation (AF) and ischemic stroke, raising the question as to whether such patients, even when still in sinus rhythm without documented AF, could benefit from oral anticoagulation. AF and A-IAB are both markers of stroke. The anatomical substrate in both is fibrotic atrial cardiomyopathy, resulting in atrial electromechanical dyssynchrony, dysfunction, and left atrial remodelling, that favour blood stasis and hypercoagulation. Under these conditions thrombogenic cascade may be triggered, resulting in systemic embolization. Before proposing oral anticoagulation in the management of selected patients with A-IAB, as is currently recommended in patients with AF and high CHA2DS2-Vasc score, a randomized clinical trial will have to demonstrate efficacy and safety of anticoagulation in this setting. In the meantime, an individualized approach may be considered based on the recognition of those patients at a higher risk of stroke. These may be elderly patients with A-IAB and several risk factors and, thus, with a high CHA2DS2-Vasc score and the presence of environmental arrhythmias.
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Rational and design of the Baseline Interatrial Block and Transcatheter aortic valve implantation (BIT) registry.
Journal of Electrocardiology, 2019Co-Authors: Manuel Martínez-sellés, Ana Ayesta, Luis Alberto Escobar-robledo, Eva Bernal, Luis Nombela, Juan José Gómez-doblas, Diego López-otero, Hugo González-saldívar, Clara Fernández-cordón, Antonio Bayés-de-lunaAbstract:Abstract Background Aortic stenosis (AS) is currently the most frequent heart valve disease. Symptomatic severe AS has a poor prognosis and transcatheter aortic valve implantation (TAVI) is becoming the therapy of choice in these patients. Changes in the conduction tissue after the procedure constitute one of the main limitations of TAVI, with a frequent need for a definitive pacemaker. Interatrial Block (IAB) is defined as a prolonged P-wave duration and is related with atrial fibrosis. The presence of IAB could be a marker of conduction tissue abnormalities at other levels. No study has specifically analyzed the role of IAB as a predictor of the need for permanent pacemaker in patients with AS undergoing TAVI. Methods The Baseline Interatrial Block and Transcatheter aortic valve implantation (BIT) registry will be performed in approximately 3000 patients with severe AS treated with TAVI. A centralized analysis of baseline ECGs will study the presence and type of IAB and other ECG data (rhythm, P-wave duration, PR and QRS intervals/intraventricular conduction disorders). Clinical follow-up will be carried out by local researchers. The primary endpoint will be the requirement of permanent pacemaker during post-TAVI hospitalization. As secondary objectives, the incidence of new onset AF, stroke, or mortality during follow-up will be analyzed. Secondary endpoints will include the incidence of new onset AF, stroke, or mortality during follow-up. Conclusion The BIT registry will study, for the first time, the influence of previous IAB in the need of permanent pacemaker after TAVI: This large registry will also provide information regarding the association of this and other ECG parameters with prognosis.
Martínez Sellés Oliveria Soares Manuel - One of the best experts on this subject based on the ideXlab platform.
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Advanced Interatrial Block and P-wave duration are associated with atrial fibrillation and stroke in older adults with heart disease: The BAYES registry
'Oxford University Press (OUP)', 2020Co-Authors: Martínez Sellés Oliveria Soares Manuel, Bayés De Luna, Antoni, Baranchuk Adrian, Bayés Genís Antoni, Elosua Roberto, Ibarrola Martín, Mireia De ,andrés, Díez Villanueva Pablo, Bayes Registry InvestigatorsAbstract:Aims Advanced Interatrial Block (IAB), is an unrecognized surrogate of atrial dysfunction and a trigger of atrial dysrhythmias, mainly atrial fibrillation (AF). Our aim was to prospectively assess whether advanced IAB in sinus rhythm is associated with AF and stroke in elderly outpatients with structural heart disease, a group not previously studied. Methods and results Prospective observational registry that included outpatients aged ≥70 years with structural heart disease and no previous diagnosis of AF. Patients were divided into three groups: normal P-wave duration (
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Interatrial Block can occur in the absence of left atrial enlargement: New experimental model
'Wiley', 2020Co-Authors: Guerra, José M., Bayés De Luna, Antoni, Baranchuk Adrian, Martínez Sellés Oliveria Soares Manuel, Vilahur Gemma, Cabrera Rodríguez, José Ángel, Mendieta Guiomar, Sánchez Quintana DamiánAbstract:We present the surface electrocardiogram of an open‐chest anesthetized healthy adult swine after direct application of ice at the transversus sinus of the pericardium where the Bachmann's region is located. Gradual and transient Interatrial Block (IAB) in the absence of structural atrial disease is described. This new experimental model demonstrated that IAB is an independent entity from left atrial enlargement.SIN FINANCIACIÓN1.340 JCR (2018) Q4, 113/136 Cardiac & Cardiovascular Systems, 64/80 Engineering, BiomedicalUE
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Relation of Advanced Interatrial Block to Risk of Atrial Fibrillation and Stroke
'Elsevier BV', 2020Co-Authors: Bayés De Luna, Antoni, Baranchuk Adrian, Martínez Sellés Oliveria Soares Manuel, Bayés Genís Antoni, Elosua Roberto, Mendieta Guiomar, Breithardt GünterAbstract:Advanced Interatrial Block (A-IAB) has been associated to atrial fibrillation (AF) and ischemic stroke, raising the question as to whether such patients, even when still in sinus rhythm without documented AF, could benefit from oral anticoagulation. AF and A-IAB are both markers of stroke. The anatomical substrate in both is fibrotic atrial cardiomyopathy, resulting in atrial electromechanical dyssynchrony, dysfunction, and left atrial remodelling, that favour blood stasis and hypercoagulation. Under these conditions thrombogenic cascade may be triggered, resulting in systemic embolization. Before proposing oral anticoagulation in the management of selected patients with A-IAB, as is currently recommended in patients with AF and high CHA2DS2-Vasc score, a randomized clinical trial will have to demonstrate efficacy and safety of anticoagulation in this setting. In the meantime, an individualized approach may be considered based on the recognition of those patients at a higher risk of stroke. These may be elderly patients with A-IAB and several risk factors and, thus, with a high CHA2DS2-Vasc score and the presence of environmental arrhythmias.SIN FINANCIACIÓN2.843 JCR (2018) Q2, 59/136 Cardiac & Cardiovascular SystemsUE
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Rational and design of the Baseline Interatrial Block and Transcatheter aortic valve implantation (BIT) registry
'Elsevier BV', 2019Co-Authors: Martínez Sellés Oliveria Soares Manuel, Escobar-robledo, Luis Alberto, Bernal Eva, Nombela Luis, Ayesta Ana, Gómez Doblas J. J., López Otero Diego, González Saldivar Hugo, Fernández Cordón Clara, Ariza Solé AlbertAbstract:Background Aortic stenosis (AS) is currently the most frequent heart valve disease. Symptomatic severe AS has a poor prognosis and transcatheter aortic valve implantation (TAVI) is becoming the therapy of choice in these patients. Changes in the conduction tissue after the procedure constitute one of the main limitations of TAVI, with a frequent need for a definitive pacemaker. Interatrial Block (IAB) is defined as a prolonged P-wave duration and is related with atrial fibrosis. The presence of IAB could be a marker of conduction tissue abnormalities at other levels. No study has specifically analyzed the role of IAB as a predictor of the need for permanent pacemaker in patients with AS undergoing TAVI. Methods The Baseline Interatrial Block and Transcatheter aortic valve implantation (BIT) registry will be performed in approximately 3000 patients with severe AS treated with TAVI. A centralized analysis of baseline ECGs will study the presence and type of IAB and other ECG data (rhythm, P-wave duration, PR and QRS intervals/intraventricular conduction disorders). Clinical follow-up will be carried out by local researchers. The primary endpoint will be the requirement of permanent pacemaker during post-TAVI hospitalization. As secondary objectives, the incidence of new onset AF, stroke, or mortality during follow-up will be analyzed. Secondary endpoints will include the incidence of new onset AF, stroke, or mortality during follow-up. Conclusion The BIT registry will study, for the first time, the influence of previous IAB in the need of permanent pacemaker after TAVI: This large registry will also provide information regarding the association of this and other ECG parameters with prognosis.SIN FINANCIACIÓN1.166 JCR (2018) Q4, 119/136 Cardiac & Cardiovascular SystemsUE
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Prevalence and Significance of Interatrial Block in Takotsubo Syndrome (from the RETAKO Registry)
'Elsevier BV', 2019Co-Authors: Martín-demiguel Irene, Núñez Gil, Iván J., Pérez-castellanos Alberto, Vedia Óscar, Uribarri Aitor, Durán-cambra Albert, Martín-garcía Agustín, Corbí Pascual Miguel, Guillén Marzo Marta, Martínez Sellés Oliveria Soares ManuelAbstract:Interatrial Block (IAB) represents a conduction delay between right and left atria and is associated with an increased risk of atrial fibrillation and stroke. IAB has not been previously assessed in patients with Takotsubo syndrome (TS). Our aim was to describe the prevalence and prognostic significance of IAB in patients with TS. Data come from the Spanish National prospective registry of patients with definitive TS diagnosis. IAB was defined as a P-wave ≥120 ms and was considered partial when the P-wave was positive in inferior leads and advanced when it was biphasic (+/−). A total of 246 patients were included, normal P-wave was found in 151 (61%), partial IAB in 58 (24%), atrial fibrillation in 18 (7%), advanced IAB in 13 (5%), and 6 (2%) were pacemaker dependent. During a mean follow up of 12 months the composite of all-cause mortality and hospital readmission was significantly higher in patients with advanced IAB (31%) or atrial fibrillation (33%) than in the rest of the cohort (pacemaker stimulation 17%, normal P-wave 13%, partial IAB 12%), p < 0.01. The data regarding P wave characteristics were an independent predictor of the composite end point all-cause death and hospital readmission. IAB has a high prevalence in patients with TS. Advanced IAB and atrial fibrillation are associated with a poor prognosis.SIN FINANCIACIÓN2.843 JCR (2018) Q2, 59/136 Cardiac & Cardiovascular SystemsUE
Christodoulos Stefanadis - One of the best experts on this subject based on the ideXlab platform.
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Prevalence of Interatrial Block in patients with Friedreich's Ataxia
International Journal of Cardiology, 2010Co-Authors: Marios Panas, Elias Gialafos, K. Spengos, Theodore G. Papaioannou, Konstantina Aggeli, Athina Kladi, Gerasimos Siasos, John Gialafos, Dimitrios Vassilopoulos, Christodoulos StefanadisAbstract:Abstract Interatrial Block is a predictor of atrial arrhythmias. Aim of the present study was to estimate the prevalence of Interatrial Block (IAB) in Friedreich's Ataxia (FA) compared to controls and correlate it with echocardiographic and genetic features. Methods IAB, defined as an electrocardiographic (ECG) derived P-wave duration >120ms, echocardiographic variables and genetic markers were evaluated in 23 FA patients with no manifestation of cardiac involvement and were compared to 23 sex- and age-matched controls. Results IAB was significantly more frequent among FA patients compared to controls (11/23 vs 1/23, p Conclusion Early recognition of IAB could allow the identification of asymptomatic FA patients who are prone to develop potentially life-threatening arrhythmias.
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Prevalence of Interatrial Block in healthy school-aged children: definition by P-wave duration or morphological analysis.
Annals of Noninvasive Electrocardiology, 2010Co-Authors: Polychronis Dilaveris, Leonidas Raftopoulos, Georgios Giannopoulos, Stylianos Katinakis, Dimitrios Maragiannis, Dimitrios Roussos, Konstantinos Gatzoulis, Andreas P. Michaelides, Christodoulos StefanadisAbstract:Background: P waves ≥110 ms in adults and ≥90 ms in children are considered abnormal, signifying Interatrial Block, particularly in the first case. Methods: To evaluate the prevalence of Interatrial Block in healthy school-aged children, we obtained 12-lead digital ECGs (Cardioperfect 1.1, CardioControl NV, Delft, The Netherlands) of 664 healthy children (349 males/315 females, age range 6–14 years old). P-wave analysis indices [mean, maximum and minimum (in the 12 leads) P-wave duration, P-wave dispersion, P-wave morphology in the derived orthogonal (X, Y, Z) leads, as well the amplitude of the maximum spatial P-wave vector] were calculated in all study participants. Results: P-wave descriptor values were: mean P-wave duration 84.9 ± 9.5 ms, maximum P-wave duration 99.0 ± 9.8 ms, P dispersion 32.2 ± 12.5 ms, spatial P amplitude 182.7 ± 69.0 μV. P-wave morphology distribution in the orthogonal leads were: Type I 478 (72.0%), Type II 178 (26.8%), Type III 1 (0.2%), indeterminate 7 (1%). Maximum P-wave duration was positively correlated to age (P < 0.001) and did not differ between sexes (P = 0.339). Using the 90-ms value as cutoff for P-wave duration, 502 (75.6%) children would be classified as having maximum P-wave duration above reference range. The 95th and the 99th percentiles were in the overall population 117 ms and 125 ms, respectively. P-wave morphology type was not in any way correlated to P-wave duration (P = 0.715). Conclusions: Abnormal P-wave morphology signifying the presence of Interatrial Block is very rare in a healthy pediatric population, while widened P waves are quite common, although currently classified as abnormal. Ann Noninvasive Electrocardiol 2010;15(1):17–25
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prevalence of Interatrial Block in young healthy men 35 years of age
American Journal of Cardiology, 2007Co-Authors: Elias Gialafos, Theodore G. Papaioannou, John Gialafos, Theodora Psaltopoulou, Andreas Synetos, Polychronis Dilaveris, George Andrikopoulos, Konstantinos Vlasis, Christodoulos StefanadisAbstract:Interatrial Block (IAB; P-wave duration ≥110 ms) is highly prevalent and is strongly associated with atrial tachyarrhythmias and left atrial dysfunction. Very few studies have examined IAB in young healthy subjects. The aim of the present study was to demonstrate the prevalence of IAB and its possible relation with clinical variables in 1,353 young healthy men. It was found that 9.1% of healthy men aged 3 , and V 5 was also observed. Age and heart rate were independent significant determinants of IAB. In conclusion, IAB is a frequent phenomenon, even at young ages. Thus, the early recognition of IAB might be important, possibly contributing to the prevention of future cardiovascular complications.
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Prevalence of Interatrial Block in Young Healthy Men
American Journal of Cardiology, 2007Co-Authors: Elias Gialafos, Theodore G. Papaioannou, John Gialafos, Theodora Psaltopoulou, Andreas Synetos, Polychronis Dilaveris, George Andrikopoulos, Konstantinos Vlasis, Christodoulos StefanadisAbstract:Interatrial Block (IAB; P-wave duration ≥110 ms) is highly prevalent and is strongly associated with atrial tachyarrhythmias and left atrial dysfunction. Very few studies have examined IAB in young healthy subjects. The aim of the present study was to demonstrate the prevalence of IAB and its possible relation with clinical variables in 1,353 young healthy men. It was found that 9.1% of healthy men aged 3 , and V 5 was also observed. Age and heart rate were independent significant determinants of IAB. In conclusion, IAB is a frequent phenomenon, even at young ages. Thus, the early recognition of IAB might be important, possibly contributing to the prevention of future cardiovascular complications.
Adrian Baranchuk - One of the best experts on this subject based on the ideXlab platform.
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Interatrial Block and cognitive impairment in the BAYES prospective registry.
International Journal of Cardiology, 2020Co-Authors: Manuel Martínez-sellés, Adrian Baranchuk, Antoni Bayes-genis, M. Esther Martínez-larrú, Martin Ibarrola, Alba Santos, Pablo Díez-villanueva, Antonio Bayés-de-luna, Roberto ElosuaAbstract:Abstract Background An association between Interatrial Block (IAB) (P wave duration ≥120 ms) and dementia has been suggested. Our objective was to assess the association of IAB with cognitive impairment (CI). Methods The prospective BAYES registry included 552 patients ≥70 years with structural heart disease without documented atrial fibrillation. Cognitive ability was assessed at baseline and every 6 months with the Pfeiffer test. The median follow-up was 22 months. Results Thirty patients (5.4%) had baseline CI, 20 patients with mild CI and 10 with moderate CI. Compared to patients without CI, patients with CI had higher mean age (80.4 ± 6.5 vs. 76.8 ± 5.4 years) and higher prevalence of advanced IAB (with biphasic P-wave ± in inferior leads) (14 [46.7%] vs. 122 [23.4%], p Conclusion In patients aged 70 years or more with structural heart disease who are in sinus rhythm advanced IAB is associated with baseline CI. There is also an association of partial and advanced IAB with CI during follow-up.
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Interatrial Block can occur in the absence of left atrial enlargement: New experimental model.
Pacing and Clinical Electrophysiology, 2020Co-Authors: Jose M. Guerra, Adrian Baranchuk, Antoni Bayés De Luna, Manuel Martínez-sellés, Gemma Vilahur, José Angel Cabrera, Guiomar Mendieta, Damián Sánchez-quintanaAbstract:We present the surface electrocardiogram of an open-chest anesthetized healthy adult swine after direct application of ice at the transversus sinus of the pericardium where the Bachmann's region is located. Gradual and transient Interatrial Block (IAB) in the absence of structural atrial disease is described. This new experimental model demonstrated that IAB is an independent entity from left atrial enlargement.
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Relation of Advanced Interatrial Block to Risk of Atrial Fibrillation and Stroke
American Journal of Cardiology, 2020Co-Authors: Antoni Bayés-de-luna, Adrian Baranchuk, Manuel Martínez-sellés, Roberto Elosua, Guiomar Mendieta, Antoni Bayes-genis, Günter BreithardtAbstract:Advanced Interatrial Block (A-IAB) has been associated to atrial fibrillation (AF) and ischemic stroke, raising the question as to whether such patients, even when still in sinus rhythm without documented AF, could benefit from oral anticoagulation. AF and A-IAB are both markers of stroke. The anatomical substrate in both is fibrotic atrial cardiomyopathy, resulting in atrial electromechanical dyssynchrony, dysfunction, and left atrial remodelling, that favour blood stasis and hypercoagulation. Under these conditions thrombogenic cascade may be triggered, resulting in systemic embolization. Before proposing oral anticoagulation in the management of selected patients with A-IAB, as is currently recommended in patients with AF and high CHA2DS2-Vasc score, a randomized clinical trial will have to demonstrate efficacy and safety of anticoagulation in this setting. In the meantime, an individualized approach may be considered based on the recognition of those patients at a higher risk of stroke. These may be elderly patients with A-IAB and several risk factors and, thus, with a high CHA2DS2-Vasc score and the presence of environmental arrhythmias.
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Second-degree Interatrial Block: A case series.
Journal of Electrocardiology, 2019Co-Authors: Chang Nancy Wang, Antonio Bayes De Luna, Juan Manzzardo, Damián Longo, Rachel E. Green, Adrian BaranchukAbstract:Abstract Advanced Interatrial Block (IAB) (P-wave ≥120 ms and biphasic P-wave in leads II, III and aVF) is a prevalent ECG pattern frequently associated with supraventricular arrhythmias and stroke, especially in patients with structural heart disease. Intermittent IAB is a much more poorly defined electrocardiographic entity with uncertain clinical significance. In this case series, we review and analyze eight cases of second degree intermittent IAB. In six cases, there is normalization of advanced IAB after a premature supraventricular or ventricular contraction, suggesting a functional Block that temporarily recovers post extra-systolic pause. Recognition of intermittent IAB (second degree) may help further characterize the prognostic and clinical implications of this ECG pattern.
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Second-degree Interatrial Block: Brief review and concept.
Annals of Noninvasive Electrocardiology, 2018Co-Authors: Antonio Bayes De Luna, Adrian Baranchuk, Manuel Martínez-sellés, Roberto Elosua, César Niño Pulido, A. Bayes-genis, Marcelo V. ElizariAbstract:The advanced Interatrial Block (A-IAB) (P ≥ 120 ms plus ± pattern in II, III and aVF) corresponds at atrial level, to right or left advanced bundle branch Block at ventricular level, and it is well known that these patterns may be seen transiently in relation to taquicardia or bradycardia (tachycardia or bradycardia dependent right or left bundle branch Block). We present for the first time, the same phenomenon at atrial level. In one case, the A-IAB appears in relation to tachycardization and in the other disappears during a pause induced by ventricular premature complex.