Martínez-Sellés Manuel, Baranchuk Adrian, Elosua Roberto, de Luna Antonio Bayés
Department of Cardiology, Hospital General Universitario Gregorio Marañón, Universidad Europea, Universidad Complutense, Madrid, Spain.
Division of Cardiology, Queen's University, Kingston, Ontario, Canada.
Clin Cardiol. 2017 Apr;40(4):196-199. doi: 10.1002/clc.22647. Epub 2016 Nov 24.
The prevalence of interatrial block (IAB) is high in the elderly, particularly in those with heart disease. Despite this high prevalence-and the association of IAB with the risk of atrial fibrillation (AF), stroke, and cognitive decline-little information exists about the prognosis of older patients with IAB. P-wave duration and morphology are associated with risk of developing AF, stroke, and cognitive decline in elderly patients with structural heart disease. The aim of the Interatrial Block and Yearly Events (BAYES) registry is to assess the impact of IAB on the risk of AF and stroke during 3 years of follow-up. A series of 654 ambulatory patients age ≥70 years with heart disease from 35 centers will be included in 3 similar-size groups of patients. Group A: normal P-wave duration (<120 ms); Group B: partial IAB (P-wave duration ≥120 ms without biphasic [plus/minus] morphology in the inferior leads II, III, and aVF); and Group C: advanced IAB (P-wave duration ≥120 ms with biphasic [plus/minus] morphology in the inferior leads II, III, and aVF). Patients will be managed according to current recommendations. The 2 primary endpoints are defined as (1) AF duration >5 minutes and documented in any form of electrocardiographic recording; and (2) stroke. Results from this study might significantly improve the knowledge of IAB and its impact on the outcome of elderly patients with heart disease and could open the door to the use of anticoagulation therapy in some elderly patients with IAB.
心房传导阻滞(IAB)在老年人中患病率很高,尤其是在患有心脏病的人群中。尽管患病率很高,且IAB与心房颤动(AF)、中风和认知功能下降的风险相关,但关于老年IAB患者的预后信息却很少。P波持续时间和形态与患有结构性心脏病的老年患者发生AF、中风和认知功能下降的风险相关。心房传导阻滞与年度事件(BAYES)注册研究的目的是评估IAB在3年随访期间对AF和中风风险的影响。来自35个中心的一系列654名年龄≥70岁的患有心脏病的门诊患者将被纳入3个规模相似的患者组。A组:P波持续时间正常(<120毫秒);B组:部分IAB(P波持续时间≥120毫秒,下壁导联II、III和aVF无双向[正负]形态);C组:晚期IAB(P波持续时间≥120毫秒,下壁导联II、III和aVF有双向[正负]形态)。患者将根据当前建议进行管理。2个主要终点定义为:(1)AF持续时间>5分钟,并以任何形式的心电图记录证实;(2)中风。这项研究的结果可能会显著提高对IAB及其对老年心脏病患者结局影响的认识,并可能为一些老年IAB患者使用抗凝治疗打开大门。