Boccanelli Alessandro, Mureddu Gian Francesco, Cesaroni Giulia, Prati Francesco, Rangoni Fabio, Agabiti Nera, Davoli Marina, Scardovi Angela Beatrice, Latini Roberto
Casa di Cura Quisisana, Rome, Italy.
Azienda Ospedaliera S. Giovanni-Addolorata, Rome, Italy.
J Electrocardiol. 2019 May-Jun;54:22-27. doi: 10.1016/j.jelectrocard.2019.02.011. Epub 2019 Feb 28.
The principal aims of this prospective multicentre study were to relate the presence of interatrial block (IAB) with a late occurrence of atrial fibrillation (AF) and to demonstrate the independence of the IAB effect on risk of AF from structural cardiac alterations.
This prospective study was the follow-up of subjects included in the PREDICTOR cross-sectional population-based study. Subjects were divided into groups according to IAB status. Socio-demographic and health characteristic were collected during enrolment in the PREDICTOR along with ECGs, echocardiograms and NT-proBNP dosages. Follow up was performed on administrative data. The mean time of follow up was 6.6 years.
1626 subjects were included in the analysis. Four hundred-fifteen subjects out of 1626 (25.5%) had IAB. The survival analysis suggests an association between IAB alone and AF (HR = 1.50, p = 0.058) and, in normal-weight subjects, IAB strongly predicted AF indicating more than triple the risk (HR = 3.05; p = 0.002 95% CI: 1.51-6.18). The association seems to be independent of possible confounders such as history of IHD, left ventricular hypertrophy, CHA2DS2-VASc, left atrial dimension, or NT-proBNP dosage.
Our analysis suggests that IAB is an electric condition that can increase the risk of AF independently of any structural cardiac alterations, at least in normal-weight subjects.
这项前瞻性多中心研究的主要目的是将心房传导阻滞（IAB）的存在与房颤（AF）的晚期发生相关联，并证明IAB对房颤风险的影响独立于心脏结构改变。
这项前瞻性研究是对纳入基于人群的横断面PREDICTOR研究的受试者进行的随访。根据IAB状态将受试者分组。在PREDICTOR研究入组期间收集社会人口统计学和健康特征，同时收集心电图、超声心动图和NT-proBNP剂量。根据行政数据进行随访。平均随访时间为6.6年。
1626名受试者纳入分析。1626名受试者中有415名（25.5%）患有IAB。生存分析表明，单独的IAB与AF之间存在关联（HR = 1.50，p = 0.058），在体重正常的受试者中，IAB强烈预测AF，表明风险增加两倍以上（HR = 3.05；p = 0.002，95%CI：1.51 - 6.18）。这种关联似乎独立于可能的混杂因素，如缺血性心脏病史、左心室肥厚、CHA2DS2-VASc、左心房大小或NT-proBNP剂量。
我们的分析表明，IAB是一种电生理状态，至少在体重正常的受试者中，它可独立于任何心脏结构改变而增加AF风险。
