Interatrial block was present in 47.3% of sinus rhythm ECGs, but was officially documented by a cardiologist in only 0.32% of cases, demonstrating severe clinical underappreciation.
Cross-Sectional (n=730)
No
How frequently is interatrial block (IAB) diagnosed by clinicians compared to its actual prevalence in a general hospital population?
Interatrial block is highly prevalent in a general hospital population but is severely underdiagnosed by clinicians.
INTRODUCTION: Interatrial block (IAB; P wave > or =110 ms), a conduction delay between the right and left atria (LA), is highly prevalent and strongly associated with atrial tachyarrhythmias, LA electromechanical dysfunction as well as a risk of embolism. Nonetheless, clinicians' underappreciation of its existence and sequelae remains. We appraised this issue in a general hospital population. METHODS: From the database of 730 12-lead electrocardiograms (ECGs) of patients aged 17-98 years (mean age 67.80 years; female patients 53.56%) in a tertiary care teaching general hospital, we recorded the computer-generated diagnostic readings of the ECGs and also the official cardiologist and hospitalist ECG interpretations and documentations. For increased sensitivity and specificity, and because the mode P wave duration in IAB is 120 ms, P waves > or =120 ms in any lead were used to diagnose IAB. RESULTS: Six hundred and fifty-three ECGs (89.45%) showed sinus rhythm, and of those, IAB was documented on 309 ECGs (47.32%). LA enlargement was cited 29 times (3.97%), while possible LA enlargement and biatrial enlargement were cited 17 (2.32%) and 6 times (0.82%), respectively. One cardiologist's ECG interpretation documented IAB (0.32%), but none of the other medical staff diagnosed IAB or abnormal P wave duration. CONCLUSION: This study demonstrates to extremes how IAB went undiagnosed in a general hospital population. Until more awareness of IAB is cultivated, such ignorance of the existence and sequelae of IAB could continue. Configuring ECG software to include P wave durations in computer-generated ECG readings could be useful in aiding diagnosis.
Ariyarajah et al. (Sat,) conducted a cross-sectional in Interatrial block (n=730). Interatrial block was evaluated on Clinical documentation of interatrial block by medical staff. Interatrial block was present in 47.3% of sinus rhythm ECGs, but was officially documented by a cardiologist in only 0.32% of cases, demonstrating severe clinical underappreciation.