García-Izquierdo Jaén Eusebio, Cobo Rodríguez Pablo, Solís Solís Luis, Pham Trung Chinh, Jiménez Sánchez Diego, Sánchez García Manuel, Castro Urda Victor, Toquero Ramos Jorge, Fernández Lozano Ignacio
Unidad de Arritmias, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España.
Unidad de Arritmias, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España.
Arch Cardiol Mex. 2018 Dec;88(5):369-375. doi: 10.1016/j.acmx.2017.09.004. Epub 2017 Nov 3.
Interatrial block (IAB) is a well-known entity that is associated with an increased risk of atrial fibrillation (AF). This association is called Bayes' syndrome. The aim of our study was to define the prevalence of IAB among patients younger than 65 years undergoing cardiac surgery and determine whether there is an association between the presence of interatrial conduction delay and postoperative atrial fibrillation (POAF).
A total of 207 patients were enrolled. Partial IAB was defined as P-wave>120ms. Advanced IAB was defined as P-wave>120ms+biphasic morphology in the inferior leads. Ocurrence of POAF was assessed and a comparative analysis was conducted between patients that did and did not develop AF.
IAB prevalence was 78.3% (partial 66.2%, advanced 12.1%). POAF occurred in 28.5% of all patients, and was more frequent among patients with advanced IAB (44%) compared to 27.7% and 24.4% of POAF among patients with partial IAB and without IAB, respectively. Patients who developed POAF were significantly older, had significantly higher NTproBNP, higher prevalence of atrial enlargement and thyroid disease. After multivariate analysis, advanced IAB was found to be independently associated with POAF.
IAB is a frequent finding among patients undergoing cardiac surgery. According to our results, advanced IAB is independently associated with POAF in younger patients (<65 years) undergoing cardiac surgery.
房间阻滞(IAB)是一种已知的与心房颤动(AF)风险增加相关的情况。这种关联被称为贝叶斯综合征。我们研究的目的是确定在接受心脏手术的65岁以下患者中IAB的患病率,并确定房间传导延迟的存在与术后心房颤动(POAF)之间是否存在关联。
共纳入207例患者。部分IAB定义为P波>120ms。高级IAB定义为P波>120ms且下壁导联呈双相形态。评估POAF的发生情况,并对发生和未发生AF的患者进行比较分析。
IAB患病率为78.3%(部分66.2%,高级12.1%)。所有患者中POAF发生率为28.5%,高级IAB患者中POAF更常见(44%),而部分IAB患者和无IAB患者中POAF发生率分别为27.7%和24.4%。发生POAF的患者年龄显著更大,NTproBNP显著更高,心房扩大和甲状腺疾病的患病率更高。多因素分析后,发现高级IAB与POAF独立相关。
IAB在接受心脏手术的患者中很常见。根据我们的结果,高级IAB与接受心脏手术的年轻患者(<65岁)的POAF独立相关。