Relation of interatrial block to new-onset atrial fibrillation in patients with Chagas cardiomyopathy and implantable cardioverter-defibrillators.

Abstract

Chagas cardiomyopathy is an endemic disease in Latin America. A significant proportion of patients develop atrial fibrillation (AF), which may result in stroke and increased morbidity or mortality. Interatrial block (IAB) has been associated with the development of AF in different clinical scenarios. The aim of our study was to determine whether IAB can predict new-onset AF in patients with Chagas cardiomyopathy and implantable cardioverter-defibrillators (ICDs). We conducted a retrospective study of patients with Chagas cardiomyopathy and ICDs from 14 centers in Latin America. Demographics, clinical, and device follow-up were collected. Surface electrocardiograms were scanned at 300 dpi and maximized ×8. Semiautomatic calipers were used to determine P-wave onset and offset. Partial IAB was defined as a P wave of >120 ms and advanced IAB as a P wave of >120 ms with biphasic morphology (±) in inferior leads. AF events and ICD therapies were reviewed during follow-up by 2 independent investigators. A total of 80 patients were analyzed. Mean age was 54.6 ± 10.4 years, and 52 (65%) were male. Mean left ventricular ejection fraction was 40 ± 12%. IAB was detected in 15 patients (18.8%), with 8 (10.0%) partial and 7 (8.8%) advanced. During a follow-up of 33 ± 20 months, 11 patients (13.8%) presented with new AF. IAB (partial + advanced) was strongly associated with new AF (p <0.0001) and inappropriate therapy by the ICD (p = 0.014). In conclusion, IAB (partial + advanced) predicted new-onset AF in patients with Chagas cardiomyopathy and ICDs.

• Authors: Andres Enriquez, Diego Conde, Francisco Femenia, Antoni Bayés de Luna, Antonio Ribeiro, Claudio Muratore, Mariana Valentino, Enrique Retyk, Nestor Galizio, Wilma M Hopman, Adrian Baranchuk
• Journal: The American journal of cardiology (Am J Cardiol) Vol. 113 Issue 10 Pg. 1740-3 (May 15 2014) ISSN: 1879-1913 [Electronic] United States
• PMID: 24698463 (Publication Type: Journal Article, Multicenter Study)
• Copyright: Copyright © 2014 Elsevier Inc. All rights reserved.

Topics

• Atrial Fibrillation (etiology, physiopathology, therapy)
• Chagas Cardiomyopathy (complications, physiopathology, therapy)
• Defibrillators, Implantable
• Electrocardiography
• Female
• Follow-Up Studies
• Heart Atria
• Heart Conduction System (physiopathology)
• Humans
• Male
• Middle Aged
• Retrospective Studies
• Ventricular Function, Left