Cargando…
Surface ECG interatrial block-guided treatment for stroke prevention: rationale for an attractive hypothesis
Atrial fibrillation (AF) is the most common sustained arrhythmia and is associated with stroke, cognitive impairment, and cardiovascular death. Some predisposing factors − as aging, diabetes, hypertension − induce and maintain electrophysiological and ultrastructural remodeling that usually includes...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5537952/ https://www.ncbi.nlm.nih.gov/pubmed/28760133 http://dx.doi.org/10.1186/s12872-017-0650-y |
_version_ | 1783254281216851968 |
---|---|
author | Bayés de Luna, Antoni Martínez-Sellés, Manuel Bayés-Genís, Antoni Elosua, Roberto Baranchuk, Adrian |
author_facet | Bayés de Luna, Antoni Martínez-Sellés, Manuel Bayés-Genís, Antoni Elosua, Roberto Baranchuk, Adrian |
author_sort | Bayés de Luna, Antoni |
collection | PubMed |
description | Atrial fibrillation (AF) is the most common sustained arrhythmia and is associated with stroke, cognitive impairment, and cardiovascular death. Some predisposing factors − as aging, diabetes, hypertension − induce and maintain electrophysiological and ultrastructural remodeling that usually includes fibrosis. Interatrial conduction disturbances play a crucial role in the initiation of atrial fibrosis and in its associated complications. The diagnosis of interatrial blocks (IABs) is easy to perform using the surface ECG. IAB is classified as partial when the P wave duration is ≥120 ms, and advanced if the P wave also presents a biphasic pattern in II, III and aVF. IAB is very frequent in the elderly and, particularly in the case of the advanced type, is associated with AF, AF recurrences, stroke, and dementia. The anticoagulation in elderly patients at high risk of AF without documented arrhythmias is an open issue but recent data suggest that it might have a role, particularly in elderly patients with structural heart disease, high CHA(2)DS(2)VASc (Congestive heart failure/left ventricular dysfunction, Hypertension, Age ≥ 75 [doubled], Diabetes, Stroke [doubled] – Vascular disease, Age 65–74, and Sex category [female]), and advanced IAB. In this debate, we discuss the association of surface ECG IAB, a marker of atrial fibrosis, with AF and stroke. We also present the rationale that justifies further studies regarding anticoagulation in some of these patients. |
format | Online Article Text |
id | pubmed-5537952 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-55379522017-08-04 Surface ECG interatrial block-guided treatment for stroke prevention: rationale for an attractive hypothesis Bayés de Luna, Antoni Martínez-Sellés, Manuel Bayés-Genís, Antoni Elosua, Roberto Baranchuk, Adrian BMC Cardiovasc Disord Debate Atrial fibrillation (AF) is the most common sustained arrhythmia and is associated with stroke, cognitive impairment, and cardiovascular death. Some predisposing factors − as aging, diabetes, hypertension − induce and maintain electrophysiological and ultrastructural remodeling that usually includes fibrosis. Interatrial conduction disturbances play a crucial role in the initiation of atrial fibrosis and in its associated complications. The diagnosis of interatrial blocks (IABs) is easy to perform using the surface ECG. IAB is classified as partial when the P wave duration is ≥120 ms, and advanced if the P wave also presents a biphasic pattern in II, III and aVF. IAB is very frequent in the elderly and, particularly in the case of the advanced type, is associated with AF, AF recurrences, stroke, and dementia. The anticoagulation in elderly patients at high risk of AF without documented arrhythmias is an open issue but recent data suggest that it might have a role, particularly in elderly patients with structural heart disease, high CHA(2)DS(2)VASc (Congestive heart failure/left ventricular dysfunction, Hypertension, Age ≥ 75 [doubled], Diabetes, Stroke [doubled] – Vascular disease, Age 65–74, and Sex category [female]), and advanced IAB. In this debate, we discuss the association of surface ECG IAB, a marker of atrial fibrosis, with AF and stroke. We also present the rationale that justifies further studies regarding anticoagulation in some of these patients. BioMed Central 2017-07-31 /pmc/articles/PMC5537952/ /pubmed/28760133 http://dx.doi.org/10.1186/s12872-017-0650-y Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Debate Bayés de Luna, Antoni Martínez-Sellés, Manuel Bayés-Genís, Antoni Elosua, Roberto Baranchuk, Adrian Surface ECG interatrial block-guided treatment for stroke prevention: rationale for an attractive hypothesis |
title | Surface ECG interatrial block-guided treatment for stroke prevention: rationale for an attractive hypothesis |
title_full | Surface ECG interatrial block-guided treatment for stroke prevention: rationale for an attractive hypothesis |
title_fullStr | Surface ECG interatrial block-guided treatment for stroke prevention: rationale for an attractive hypothesis |
title_full_unstemmed | Surface ECG interatrial block-guided treatment for stroke prevention: rationale for an attractive hypothesis |
title_short | Surface ECG interatrial block-guided treatment for stroke prevention: rationale for an attractive hypothesis |
title_sort | surface ecg interatrial block-guided treatment for stroke prevention: rationale for an attractive hypothesis |
topic | Debate |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5537952/ https://www.ncbi.nlm.nih.gov/pubmed/28760133 http://dx.doi.org/10.1186/s12872-017-0650-y |
work_keys_str_mv | AT bayesdelunaantoni surfaceecginteratrialblockguidedtreatmentforstrokepreventionrationaleforanattractivehypothesis AT martinezsellesmanuel surfaceecginteratrialblockguidedtreatmentforstrokepreventionrationaleforanattractivehypothesis AT bayesgenisantoni surfaceecginteratrialblockguidedtreatmentforstrokepreventionrationaleforanattractivehypothesis AT elosuaroberto surfaceecginteratrialblockguidedtreatmentforstrokepreventionrationaleforanattractivehypothesis AT baranchukadrian surfaceecginteratrialblockguidedtreatmentforstrokepreventionrationaleforanattractivehypothesis |