Henkens, Michiel THM;
Martinez, Helena Lopez;
Weerts, Jerremy;
Sammani, Arjan;
Raafs, Anne G;
Verdonschot, Job AJ;
van de Leur, Rutger R;
... Heymans, Stephane RB; + view all
(2022)
Interatrial Block Predicts Life-Threatening Arrhythmias in Dilated Cardiomyopathy.
Journal of the American Heart Association
, 11
(14)
, Article e025473. 10.1161/JAHA.121.025473.
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Abstract
BACKGROUND: Interatrial block (IAB) has been associated with supraventricular arrhythmias and stroke, and even with sudden cardiac death in the general population. Whether IAB is associated with life-threatening arrhythmias (LTA) and sudden cardiac death in dilated cardiomyopathy (DCM) remains unknown. This study aimed to determine the association between IAB and LTA in ambulant patients with DCM. METHODS AND RESULTS: A derivation cohort (Maastricht Dilated Cardiomyopathy Registry; N=469) and an external validation cohort (Utrecht Cardiomyopathy Cohort; N=321) were used for this study. The presence of IAB (P-wave duration>120 millisec-onds) or atrial fibrillation (AF) was determined using digital calipers by physicians blinded to the study data. In the derivation cohort, IAB and AF were present in 291 (62%) and 70 (15%) patients with DCM, respectively. LTA (defined as sudden cardiac death, justified shock from implantable cardioverter-defibrillator or anti-tachypacing, or hemodynamic unstable ventricular fi-brillation/tachycardia) occurred in 49 patients (3 with no IAB, 35 with IAB, and 11 patients with AF, respectively; median follow-up, 4.4 years [2.1; 7.4]). The LTA-free survival distribution significantly differed between IAB or AF versus no IAB (both P<0.01), but not between IAB versus AF (P=0.999). This association remained statistically significant in the multivariable model (IAB: HR, 4.8 (1.4–16.1), P=0.013; AF: HR, 6.4 (1.7– 24.0), P=0.007). In the external validation cohort, the survival distribution was also significantly worse for IAB or AF versus no IAB (P=0.037; P=0.005), but not for IAB versus AF (P=0.836). CONCLUSIONS: IAB is an easy to assess, widely applicable marker associated with LTA in DCM. IAB and AF seem to confer similar risk of LTA. Further research on IAB in DCM, and on the management of IAB in DCM is warranted.
| Type: | Article |
|---|---|
| Title: | Interatrial Block Predicts Life-Threatening Arrhythmias in Dilated Cardiomyopathy |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1161/JAHA.121.025473 |
| Publisher version: | https://doi.org/10.1161/JAHA.121.025473 |
| Language: | English |
| Additional information: | © 2022 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Cardiac & Cardiovascular Systems, Cardiovascular System & Cardiology, dilated cardiomyopathy, electrocardiography, interatrial block, life-threatening arrhythmias, non-ischemic cardiomyopathy, sudden cardiac death, SUDDEN CARDIAC DEATH, P-WAVE DURATION, ATRIAL-FIBRILLATION, ATHEROSCLEROSIS-RISK, ESC GUIDELINES, FIBROSIS, STRATIFICATION, ASSOCIATION, POPULATION, FAILURE |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics > Clinical Epidemiology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10158660 |
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