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The prevalence and prognostic significance of interatrial block in the general population
Authors:Tiia Istolahti  Antti Eranti  Heini Huhtala  Leo-Pekka Lyytikäinen  Mika Kähönen  Terho Lehtimäki
Affiliation:1. Faculty of Medicine and Health Technology, Tampere University and Finnish Cardiovascular Research Center, Tampere, Finland;2. Department of Internal Medicine, Vaasa Central Hospital, Vaasa, Finland;3. tiia.istolahti@tuni.fi;5. Heart Center, Central Hospital of North Karelia, Joensuu, Finland;6. Faculty of Social Sciences, Tampere University, Tampere, Finland;7. Heart Center, Department of Cardiology, Tampere University Hospital, Tampere, Finland;8. Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland;9. Department of Clinical Physiology, Tampere University Hospital, Tampere, Finland
Abstract:
Abstract

Introduction: Partial and advanced interatrial block (IAB) in the electrocardiographic (ECG) represents inter-atrial conduction delay. IAB is associated with atrial fibrillation (AF) and stroke in the general population.

Material and methods: A representative sample of Finnish subjects (n?=?6354) aged over 30?years (mean: 52.2?years, standard deviation: 14.6) underwent a health examination including a 12-lead ECG. Five different IAB groups based on automatic measurements were compared to normal P waves using multivariate-adjusted Cox proportional hazard model. Follow-up lasted up to 15?years.

Results: The prevalence of advanced and partial IAB was 1.0% and 9.7%, respectively. In the multivariate model, both advanced (hazard ratio (HR): 1.63 (95% confidence interval (CI): 1.00?2.65)) and partial IAB (HR: 1.39 (1.09?1.77)) were associated with increased risk of AF. Advanced IAB was associated with increased risk of stroke or transient ischaemic attack (TIA) independently of associated AF (HR: 2.22 (1.20?4.13)). Partial IAB was also associated with increased risk of being diagnosed with coronary heart disease (HR: 1.26 (1.01?1.58)).

Discussion: IAB is a rather frequent finding in the general population. IAB is a risk factor for AF and is associated with an increased risk of stroke or TIA independently of associated AF.
  • Key messages
  • Both partial and advanced interatrial block are associated with increased risk of atrial fibrillation in the general population.

  • Advanced interatrial block is an independent risk factor for stroke and transient ischaemic attack.

  • The clinical significance of interatrial block is dependent on the subtype classification.

Keywords:Interatrial block  ECG  population study  atrial fibrillation  mortality
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