Advanced interatrial block independently predicted new-onset atrial fibrillation in patients with severe congestive heart failure undergoing cardiac resynchronization therapy (OR 4.1).
Cohort (n=97)
Blinded ECG analysis
No
Does advanced interatrial block predict new-onset atrial fibrillation in patients with severe heart failure undergoing cardiac resynchronization therapy?
Advanced interatrial block on baseline ECG is an independent predictor of new-onset atrial fibrillation in patients with severe heart failure undergoing cardiac resynchronization therapy.
Effect estimate: OR 4.1 (95% CI 1.6-10.7)
Absolute Event Rate: 62% vs 28%
p-value: p=<0.003
BACKGROUND: Advanced interatrial block (aIAB) on the surface electrocardiogram (ECG), defined as a P-wave duration ≥120 milliseconds with biphasic (±) morphology in inferior leads, is frequently associated with atrial fibrillation (AF). The aim of this study was to determine whether preoperative aIAB could predict new-onset AF in patients with severe congestive heart failure (CHF) requiring cardiac resynchronization therapy (CRT). METHODS: Retrospective analysis of consecutive patients with CHF and no prior history of AF undergoing CRT for standard indications. A baseline 12-lead ECG was obtained prior to device implantation and analyzed for the presence of aIAB. ECGs were scanned at 300 DPI and maximized 8×. Semiautomatic calipers were used to determine P-wave onset and offset. The primary outcome was the occurrence of AF identified through analyses of intracardiac electrograms on routine device follow-up. RESULTS: Ninety-seven patients were included (74.2% male, left atrial diameter 45.5 ± 7.8 mm, 63% ischemic). Mean P-wave duration was 138.5 ± 18.5 milliseconds and 37 patients (38%) presented aIAB at baseline. Over a mean follow-up of 32 ± 18 months, AF was detected in 29 patients (30%) and the incidence was greater in patients with aIAB compared to those without it (62% vs 28%; P < 0.003). aIAB remained a significant predictor of AF occurrence after multivariate analysis (OR 4.1; 95% CI, 1.6-10.7; P < 0.003). CONCLUSION: The presence of aIAB is an independent predictor of new-onset AF in patients with severe CHF undergoing CRT.
Ali et al. (Mon,) conducted a cohort in Severe congestive heart failure requiring CRT (n=97). Advanced interatrial block (aIAB) vs. Absence of aIAB was evaluated on New-onset atrial fibrillation (OR 4.1, 95% CI 1.6-10.7, p=<0.003). Advanced interatrial block independently predicted new-onset atrial fibrillation in patients with severe congestive heart failure undergoing cardiac resynchronization therapy (OR 4.1).