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Association of Atrial Fibrillation in Patients With Interatrial Block Over Prospectively Followed Controls With Comparable Echocardiographic Parameters

  • Vignendra Ariyarajah
    Correspondence
    Corresponding author: Tel: 508-757-6357; fax: 813-637-3844.
    Affiliations
    Division of Cardiology, Department of Medicine, St. Boniface General Hospital, University of Manitoba, Winnipeg, Manitoba, Canada
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  • Sirin Apiyasawat
    Affiliations
    Division of Cardiology, Saint Vincent Hospital, Worcester, Massachusetts
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  • Jaxon Fernandes
    Affiliations
    Department of Medicine, Saint Vincent Hospital, Worcester, Massachusetts.
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  • Mark Kranis
    Affiliations
    Department of Medicine, Saint Vincent Hospital, Worcester, Massachusetts.
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  • Author Footnotes
    † None of the authors received any funding for this investigation. Any affiliations or financial involvement, within the past 5 years and foreseeable future with any organization or entity with a financial interest in or in financial conflict with the subject matter or materials discussed in the manuscript have been completely disclosed. Dr. Spodick receives research support from the University of Massachusetts, Worcester, Massachusetts.
    David H. Spodick
    Footnotes
    † None of the authors received any funding for this investigation. Any affiliations or financial involvement, within the past 5 years and foreseeable future with any organization or entity with a financial interest in or in financial conflict with the subject matter or materials discussed in the manuscript have been completely disclosed. Dr. Spodick receives research support from the University of Massachusetts, Worcester, Massachusetts.
    Affiliations
    Department of Medicine, Saint Vincent Hospital, Worcester, Massachusetts.

    Department of Medicine, Division of Cardiovascular Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.
    Search for articles by this author
  • Author Footnotes
    † None of the authors received any funding for this investigation. Any affiliations or financial involvement, within the past 5 years and foreseeable future with any organization or entity with a financial interest in or in financial conflict with the subject matter or materials discussed in the manuscript have been completely disclosed. Dr. Spodick receives research support from the University of Massachusetts, Worcester, Massachusetts.
Published:December 11, 2006DOI:https://doi.org/10.1016/j.amjcard.2006.08.043
      Interatrial block (IAB) (P wave ≥110 ms) is a potential risk of atrial fibrillation (AF). However, few investigations have assessed the relevance of echocardiographic parameters, particularly the contribution of its known correlate, left atrial enlargement in this regard. We identified 32 consecutive patients with comparable echocardiographic parameters, such as left atrial dimension and left ventricular ejection fraction. Patients were evaluated for IAB and followed for 15 months for cardiovascular events (heart failure, transient ischemic attacks, and stroke), atrial tachyarrhythmias (AF/atrial flutter), and death. Preexisting AF and IAB (p = 0.02) were significantly associated with future AF events. However, logistic regression analysis indicated that IAB was not an independent predictor of future AF, only preexisting atrial tachyarrhythmias was (hazard ratio 39.5, 95% confidence interval 2.7 to 576.3, p = 0.007). In conclusion, in patients with comparable echocardiographic parameters, such as left atrial size and left ventricular ejection fraction, IAB remained associated with AF after a 15-month follow-up. Additional investigation is needed to confirm the extent of the association.
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