RESUMEN
BACKGROUND: The presence of interatrial block (IAB) is associated with the development of atrial fibrillation (AF). The aim of this study was to determine whether P-wave duration and presence of IAB before the implantation of a cardiac implantable electronic device (CIED) are associated with the presence of atrial high rate episodes (AHRE), during long-term follow-up. METHODS: 380 patients (57% men; 75 ± 10 years) were included. IAB was defined according to the International Consensus Criteria. AHRE was defined as an episode of atrial rate ≥225 beats/min with a minimum duration of 5 minutes. RESULTS: Documented paroxysmal AF before the implantation was present in 24% of the patients; 80% had hypertension and 32% structural heart disease. Mean P-wave duration was 123 ± 23 ms, and 39% of the patients had IAB (32% partial, 7% advanced). After a mean follow-up of 18 ± 12 months, 33% of the patients presented AHRE. Patients with AHRE had a P-wave duration significantly longer (130 ± 24 ms vs 119 ± 21 ms; P < 0.001) and a greater prevalence of IAB (53% vs 32%; P < 0.001). In a multivariate analysis, predictors of AHRE were: IAB (odds ratio [OR] 2.1; 95% confidence interval [CI] [1.3-3.4], P < 0.001) and previous paroxysmal AF (OR 2.6; 95% CI [1.5-4.3], P < 0.001). In patients without previous AF, the presence of IAB was also a significant predictor of AHRE (OR 3.1; 95% CI [1.8-5.5], P < 0.001). CONCLUSIONS: IAB is a strong predictor of AHRE in patients with CIED. This finding is independent of the presence of prior paroxysmal AF.
Asunto(s)
Fibrilación Atrial/diagnóstico , Fibrilación Atrial/fisiopatología , Dispositivos de Terapia de Resincronización Cardíaca , Frecuencia Cardíaca/fisiología , Bloqueo Interauricular/diagnóstico , Bloqueo Interauricular/fisiopatología , Anciano , Electrocardiografía , Femenino , Humanos , Masculino , Valor Predictivo de las Pruebas , Pronóstico , Factores de RiesgoRESUMEN
A previously non-described cause of mitral regurgitation is presented. An asymptomatic 50-year old male who was casually diagnosed of mitral valve Barlow's disease underwent cardiac surgery due to severe mitral regurgitation. In the operating theatre, a longitudinal fissure of 1.5-2.0 cm length, along the posterior mitral leaflet, was found responsible for the insufficiency. This defect had features of a potential congenital origin and it was successfully repaired with direct suture. Whether it is an atypical mitral cleft, a variation of Barlow's morphology spectrum or a new congenital heart defect remains unclear.
Asunto(s)
Procedimientos Quirúrgicos Cardíacos/métodos , Cardiopatías Congénitas/complicaciones , Insuficiencia de la Válvula Mitral/etiología , Válvula Mitral/cirugía , Cardiopatías Congénitas/diagnóstico , Cardiopatías Congénitas/cirugía , Humanos , Masculino , Persona de Mediana Edad , Válvula Mitral/diagnóstico por imagen , Insuficiencia de la Válvula Mitral/diagnóstico , Insuficiencia de la Válvula Mitral/cirugía , Índice de Severidad de la EnfermedadAsunto(s)
Cateterismo Cardíaco/métodos , Procedimientos Quirúrgicos Cardíacos , Neoplasias Cardíacas/diagnóstico , Mixoma/diagnóstico , Cuidados Preoperatorios/métodos , Tomografía Computarizada por Rayos X/métodos , Tabique Interatrial , Diagnóstico Diferencial , Neoplasias Cardíacas/cirugía , Humanos , Masculino , Persona de Mediana Edad , Mixoma/cirugíaRESUMEN
No disponible
Asunto(s)
Humanos , Mixoma , Neoplasias Cardíacas , Tomografía Computarizada de Emisión/métodos , Evaluación Preoperatoria/métodosRESUMEN
No disponible
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Embolia Pulmonar/complicaciones , Embolia Pulmonar , Infarto del Miocardio/complicaciones , Infarto del Miocardio , Cateterismo Venoso Central/instrumentación , Cateterismo Venoso Central/métodos , Dolor en el Pecho/complicaciones , Dolor en el Pecho , Electrocardiografía/instrumentación , Electrocardiografía/métodos , Electrocardiografía , Disnea/complicaciones , Fibrilación AtrialAsunto(s)
Embolia Pulmonar/diagnóstico por imagen , Infarto del Miocardio con Elevación del ST/diagnóstico por imagen , Enfermedad Aguda , Anciano , Electrocardiografía , Femenino , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Ventrículos Cardíacos/diagnóstico por imagen , Humanos , Embolia Pulmonar/sangreRESUMEN
No disponible