Clinical implications of advanced inter atrial block
Antonio Bayes de Luna
Autonomous University of Barcelona, Spain
St. Pau Hospital, Spain
: Int J Cardiovas Res
Abstract
The patients with advanced interatrial block (A-IAB) (P≥120ms plus±pattern in II, III and aVF) present more frequently atrial fibrillation (Bayes syndrome) and even stroke and dementia. The following considerations have to be considered: AF is not the final cause of stroke; atrial fibrotic CM is the substrate of both AF and A-IAB; there are many similarities between these two processes. Very often A-IAB is a precursor of AF and both may be considered mediators of stroke; there is a clear evidence that A-IAB and AF are risk factors of stroke, and even dementia, and global, CV, and sudden death; in a group of patients in SR (A-IAB) that are risk factors of AF and stroke, we have to perform a randomized to demonstrate the benefits to anti-coagulate patients in SN without documented AF; if this trial is positive, we have to establish a score of risk of stroke for patients in sinus rhythm to be used at a global level; until then, we can take decisions at individual level according to the careful observations of ECG (P-wave) and other parameters (CHA2DS2-V, ambiental arrhythmias, detection of fibrosis, etc.). Recent Publications 1. Bacharova L and Wagner G S (2015) The time for naming the inter-atrial block syndrome: Bayes Syndrome. J Electrocardiol 48:133-134. 2. Martínez-Sellés M, Massó-van Roessel A, Álvarez-Garcia J, Garcia de la Villa B, Cruz-Jentoft A, Vidán M T, López J, Felix-Redondo F J, Durán J M, Bayés-Genís A, Bayés de Luna A (2016) The investigators of the Cardiac and Clinical Characterization of Centenarians (4C) registry; inter-atrial block and atrial arrhythmias in centenarians: prevalence, associations, and clinical implications. Heart Rhythm 13:645-651. 3. Fabritz L (2016) The power of P in the elderly: small biphasic wave, big impact. Heart Rhythm 13(3):653. 4. Enriquez A, Sarrias A, Villuendas R, Ali F S, Conde D, Hopman W M, Redfearn D P, Michael K, Simpson C, De Luna A B, Bayes-Genis A and Baranchuk A (2015) New-onset atrial fibrillation after cavotricuspid isthmus ablation: identification of advanced inter-atrial block is key. Europace 17:1289-1293. 5. Bayés de Luna A, Martínez-Sellés M, Bayés-Genís A, Elosua R and Baranchuk A (2017) Surface ECG inter-atrial blockguided treatment for stroke prevention: rationale for an attractive hypothesis. BMC Cardiovascular Disorders 17:211.
Biography
Antonio Bayés de Luna has been full Professor of Cardiology of Autonomous University of Barcelona, and Chairman of Cardiac Department of St. Pau Hospital of Barcelona. He has been President of Catalan, Spanish, and World Heart Federation, and also President of International Society of Cardiovascular Pharmacotherapy (ISCP). He has received many awards, including “Metge de l’any” from Catalonia, “Médico del año” of Spain (two times), “Creu de Sant Jordi” award of Generalitat of Catalonia, and “Premio Jaime I” of Generalitat of Valencia. He is member of more than 20 national societies of cardiology. He has published 306 papers, and just in the last 20 years, he has achieved H factor of 32. The number of references is more of 5.000. He has published more than 20 books, 10 as unique author. His book Clinical Electrocardiography has been translated to 10 languages.
