What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Mitral stenosis with sinus rhythm (n=159). Intervention: Advanced interatrial block vs. No interatrial block. Primary outcome: Systemic thromboembolism (OR 5.21, 95% CI 1.23-22.07, p=0.025).

What question did this study set out to answer?

This research aims to understand how often interatrial block occurs in mitral stenosis patients and its link to systemic embolism.

June 16, 2026International Journal of Aging0 citationsOpen Access

Prevalence of Interatrial Block in Mitral Stenosis and Its Association With Systemic Embolism in Patients With Sinus Rhythm: A Cross-Sectional Study

ARAbdolmohammad RanjbarTabriz University of Medical Sciences RHReza HajizadehCardiac Imaging BKBabak KazemiTabriz University of Medical Sciences

Key Result

Advanced interatrial block in patients with mitral stenosis and sinus rhythm increased the odds of systemic thromboembolism by over 5-fold compared to those without interatrial block (OR 5.21).

Key Points

This research aims to understand how often interatrial block occurs in mitral stenosis patients and its link to systemic embolism.
Cross-sectional observational study with 159 patients in Tabriz, Iran.
Participants divided into those with and without systemic thromboembolism.
Assessment of interatrial block prevalence and electrocardiogram findings.
IAB was present in 99 patients (62.26%); 16.35% had advanced IAB and 45.91% had partial IAB.
Advanced IAB increased the odds of systemic thromboembolism approximately 5-fold (OR: 5.21; 95% CI: 1.23–22.07).
No significant difference in mitral valve area between groups (P=0.639).

Study Design

Type

Cross-Sectional (n=159)

Multicenter

Yes

Structured PICO

Does the presence of interatrial block increase the risk of systemic thromboembolism in patients with mitral stenosis and sinus rhythm?

Population

159 patients (mean age 43.5 years, 79% female) with mitral stenosis and sinus rhythm evaluated in a cross-sectional study to determine the association between interatrial block and systemic embolism.

Exposure

Presence of interatrial block (advanced or partial) on ECG

Comparator

Absence of interatrial block (normal P wave duration)

Outcome

Prevalence of systemic thromboembolism, partial/advanced IAB, and P-wave dispersionhard clinical

Advanced interatrial block on ECG is an independent risk factor for systemic thromboembolic events in patients with mitral stenosis and sinus rhythm.

Main Result

Odds Ratio: 5.21 (95% CI 1.23–22.07)

p-value: p=0.025

Limitations

Low quality of ECGs in some patients leading to exclusion
Cross-sectional design prevented analyzing the dependent outcome in a time-dependent manner
Low rate of outcome (systemic thromboembolism) in the sample size
Impossible to add more confounding variables to the model to avoid overfitting

Abstract

Objectives: To investigate the prevalence of interatrial block (IAB) among mitral stenosis (MS) patients and its association with the development of systemic embolism. Setting: Tabriz, Iran. Participants: This cross-sectional observational study was conducted on 159 patients with (n=18) or without (n=141) systemic thromboembolism. Outcome Measures: Prevalence of systemic thromboembolism, partial/advanced IAB, and P-wave dispersion. Results: IAB was detected in 99 patients (62.26%), of whom 16.35% had advanced block, and 45.91% had partial block. The mitral valve area was comparable between the groups (P=0.639). The multivariate regression analysis demonstrated that the appearance of IAB in the electrocardiogram was independently associated with the occurrence of systemic thromboembolism in patients with MS. In addition, the appearance of advanced IAB in patients increased the odds of systemic thromboembolism about 5-fold compared with those without IAB (OR: 5.21; 95% CI: 1.23–22.07) and more than 3-fold higher compared to those with partial IAB (OR: 3.73; 95% CI: 1.04–13.37). Conclusions: It was revealed that advanced IAB in patients with MS and sinus rhythm is an independent risk factor for systemic thromboembolic events. Therefore, future studies can evaluate the feasibility and efficiency of preventing thromboembolic treatment to reduce mortality and morbidity in these patients.

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