Ischemic stroke in a patient with interatrial block: Is it only a coincidence or a clear relationship?
Atrial fibrillation (AF) can be detected in nearly 25% of all patients with stroke by sequentially combining different electrocardiographic methods. Prediction of early cardio-embolic stroke remain a permanent challenge in everyday practice. The early identification of an increased risk for atrial fibrillation episodes (which are frequently asymptomatic) is essential for the prevention of cardioembolic events. One of the noninvasive modalities of atrial fibrillation prediction is represented by the electrocardiographic P-wave analysis. This includes study and diagnosis of interatrial conduction block. Our short case report presents a case with ischemic cortico-sottocortical stroke involving capsulo and caudo regions in a woman patient with interatrial block as realized by electrocardiographic P analysis.
Conde D, Seoane L, Gysel M, et al. Bayés' syndrome: the association between interatrial block and supraventricular arrhythmias. Expert Rev Cardiovasc Ther 2015;13:541-50. DOI: https://doi.org/10.1586/14779072.2015.1037283
Bayés de Luna A, Cladellas M, Oter R, et al. Interatrial conduction block and retrograde activation of the Left Atrium and paroxysmal supraventricular tachyarrhythmia. Eur Heart J 1988;9:1112–8. DOI: https://doi.org/10.1093/oxfordjournals.eurheartj.a062407
Conde D, Baranchuk A. Interatrial block as anatomical-electrical substrate for supraventricular arrhythmias: Bayés syndrome. Arch Cardiol Mex 2014;84:32–40.
Spodick DH, Ariyarajah V. Interatrial block: the pandemic remains poorly perceived. Pacing Clin Electrophysiol 2009;32:667–72. DOI: https://doi.org/10.1111/j.1540-8159.2009.02343.x
Martínez-Sellés M, Massó-van Roessel A, Álvarez-García J, et al. Interatrial block and atrial arrhythmias in centenarians: Prevalence, associations, and clinical implications. Heart Rhythm 2016;13 645–51. DOI: https://doi.org/10.1016/j.hrthm.2015.10.034
Bryce A, Milden J, Bachar H, et al. New electrocardiographic score for the prediction of atrial fibrillation: The MVP ECG risk score (morphology-voltage-P-wave duration). Ann Noninvasive Electrocardiol 2019;24:e12669. DOI: https://doi.org/10.1111/anec.12669
Istolahti T, Eranti A, Huhtala H, et al. The prevalence and prognostic significance of interatrial block in the general population. Ann Med 2020;20:1-23. DOI: https://doi.org/10.1080/07853890.2020.1731759
Martínez-Sellés M. Prevalence and incidence of interatrial block in global population and in different clinical situations. J Geriatr Cardiol 2017;14:158-60.
Maheshwari A, Norby FL, Soliman EZ, et al. Refining prediction of atrial fibrillation risk in the general population with analysis of P-wave axis (from the Atherosclerosis Risk in Communities Study). Am J Cardiol 2017;120:1980-4. DOI: https://doi.org/10.1016/j.amjcard.2017.08.015
German MD, Kabir MM, Dewland TA, et al. Atrial fibrillation predictors: Importance of the electrocardiogram. Ann Noninvasive Electrocardiol 2016;21:20-9. DOI: https://doi.org/10.1111/anec.12321
Cotter PE, Martin PJ, Pugh PJ, et al. Increased incidence of interatrial block in younger adults with cryptogenic stroke and patent foramen ovale. Cerebrovasc Dis Extra 2011;1:36-43. DOI: https://doi.org/10.1159/000327346
Benito EM, De Luna AB, Baranchuk A, et al. Extensive atrial fibrosis assessed by late gadolinium enhancement cardiovascular magnetic resonance associated with advanced interatrial block electrocardiogram pattern. Europace 2017;19:377. DOI: https://doi.org/10.1093/europace/euw294
Larsen BS, Kumarathurai P, Falkenberg J. Excessive atrial ectopy and short atrial runs increase the risk of stroke beyond incident atrial fibrillation. J Am Coll Cardiol 2015;66:232-41. DOI: https://doi.org/10.1016/j.jacc.2015.05.018
Tischer Ts, Schneider R, Lauschke J, et al. Prevalence of atrial fibrillation in patients with high CHADS2- and CHA2DS2VASc-scores: anticoagulate or monitor high-risk patients? Pacing Clin Electrophysiol 2014;37:1651-7. DOI: https://doi.org/10.1111/pace.12470
Zuo ML, Liu S, Chan KH, et al. The CHADS2 and CHA 2DS 2-VASc scores predict new occurrence of atrial fibrillation and ischemic stroke. J Interv Card Electrophysiol 2013;37:47-54. DOI: https://doi.org/10.1007/s10840-012-9776-0
Bacharova L, Wagner GS. The time for naming the interatrial block Syndrome: Bayes Syndrome. J Electrocardiol 2015;48:133-4. DOI: https://doi.org/10.1016/j.jelectrocard.2014.12.022
Kumarathurai P, Mouridsen MR, Mattsson N, et al. Atrial ectopy and N-terminal pro-B-type natriuretic peptide as predictors of atrial fibrillation: a population-based cohort study. Europace 2017;19:364-70.
Bayés de Luna A, Martínez-Sellés M, Bayés-Genís A, et al. Surface ECG interatrial block-guided treatment for stroke prevention: rationale for an attractive hypothesis. BMC Cardiovasc Disord 2017;17:211. DOI: https://doi.org/10.1186/s12872-017-0650-y
Martínez-Sellés M, Fernández Lozano I, Baranchuk A, et al. Should we anticoagulate patients at high risk of atrial fibrillation? Rev Esp Cardiol 2016;69:374-6. DOI: https://doi.org/10.1016/j.rec.2016.01.008
- Abstract views: 106
- PDF: 48
Copyright (c) 2021 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.