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European Geriatric Medicine

, Volume 9, Issue 2, pp 155–159 | Cite as

Prevalence and clinical significance of interatrial block in very older persons

  • Francesc Formiga
  • Carmen Guerrero
  • Assumpta Ferrer
  • Gloria Padrós
  • Albert Ariza
Research Paper

Abstract

Purpose

The presence in older patients of an interatrial block (IAB) may be a predictor of atrial fibrillation (AF). The objective of the study was to assess in a group of very older participants: the prevalence of IAB, its association with the presence of functional and cognitive status, of new AF diagnosis and mortality after 2-year of follow-up.

Methods

A prospective subcohort of the OCTABAIX population-based study with 75 inhabitants, all 85-year-olds, at baseline in sinus rhythm were assessed. Functional and cognitive status, nutritional risk, and previous falls were recorded. Participants were classified according to the presence or absence of IAB.

Results

23 patients had IAB (30.7%). We did not observe significant differences regarding gender, comorbidity, functional status, nutritional risk and global geriatric assessment according to interatrial conduction. The patients with IAB had statistically significant better cognitive performance (p = 0.029) and a lower number of previous falls (p = 0.008). During the 2 years follow-up 3 participants (4%) died; without statistical differences between both groups. A non-significant trend to a higher incidence of new-onset AF was observed in patients with IAB (8.7 vs. 6.1%; p = 0.652).

Conclusions

Nearly one-third of very older patients with sinus rhythm have IAB. They had a tendency to higher incidence of AF and no association with mortality after 2 years of follow-up.

Keywords

Atrial fibrillation Electrocardiogram Mortality Oldest old 

Notes

Acknowledgements

Members of the Octabaix Study: J Almeda (Unitat de Suport a la Recerca de Costa de Ponent, IDIAP J Gol), T Badia (ABS Martorell Urbano), A Lobato (ABS Sant Andreu de la Barca), C Fernández (CAP Rambla), A Ferrer (CAP El Pla), F Formiga (UFISS de Geriatría, Servicio de Medicina Interna, Hospital Universitari de Bellvitge), A Gil (ABS Sant Andreu de la Barca), MJ Megido (ABS Just Oliveras), G Padrós (Laboratori Clínic L’Hospitalet), M Sarró (CAP Florida Nord) and A Tobella (ABS Martorell Rural).

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the institutional ethics committee of the Jordi Gol Institute for Primary Care Research IDIAP.

Informed consent

All patients—or the caregivers for those cognitively impaired participants—gave their written informed consent before enrollment.

References

  1. 1.
    Conde D, Baranchuk A, Bayés de Luna A (2015) Advanced interatrial block as a substrate of supraventricular tachyarrhythmias: a well recognized syndrome. J Electrocardiol 48:135–140CrossRefPubMedGoogle Scholar
  2. 2.
    Bacharova L, Wagner GS (2015) The time for naming the interatrial block syndrome: Bayes syndrome. J Electrocardiol 48:133–134CrossRefPubMedGoogle Scholar
  3. 3.
    Bernal E, Bayés-Genís A, Ariza-Solé A et al (2018) Interatrial block, frailty and prognosis in elderly patients with myocardial infarction. J Electrocardiol 51:1–7CrossRefPubMedGoogle Scholar
  4. 4.
    Ariyarajah V, Puri P, Kranis M, Wilner DA, Spodick DH (2006) Prevalence of interatrial block in the Program of All-Inclusive Care for the Elderly (PACE). Am J Geriatr Cardiol 15:174–177CrossRefPubMedGoogle Scholar
  5. 5.
    O’Neal WT, Zhang ZM, Loehr LR, Chen LY, Alonso A, Soliman EZ (2016) Electrocardiographic advanced interatrial block and atrial fibrillation risk in the general population. Am J Cardiol 117:1755–1759CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Martínez-Sellés M, Massó-van Roessel A, Álvarez-García J et al (2016) Investigators of the cardiac and clinical characterization of centenarians (4C) registry. Interatrial block and atrial arrhythmias in centenarians: prevalence, associations, and clinical implications. Heart Rhythm 13:645–651CrossRefPubMedGoogle Scholar
  7. 7.
    Ferrer A, Formiga F, Padrós G, Badia T, Almeda J, Octabaix GE (2017) The Octabaix study. Baseline assessment and 5 years of follow-up. Rev Esp Geriatr Gerontol 52:44–52CrossRefPubMedGoogle Scholar
  8. 8.
    Formiga F, Ferrer A, Mimbrera D, Badia T, Fernández C, Pujol R (2012) Grupo de Estudio Octabaix. High rate of anticoagulation therapy in oldest old subjects with atrial fibrillation: the Octabaix study. J Am Med Dir Assoc 13:8–10CrossRefPubMedGoogle Scholar
  9. 9.
    Bayés de Luna A, Platonov P, Cosio FG et al (2012) Interatrial blocks. A separate entity from left atrial enlargement: a consensus report. J Electrocardiol 45:445–451CrossRefPubMedGoogle Scholar
  10. 10.
    Singh-Manoux A, Fayosse A et al (2017) Atrial fibrillation as a risk factor for cognitive decline and dementia. Eur Heart J 38:2612–2618CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Formiga F, Ferrer A, Mestre D, Brasé A, Soldevila L, Corbella X (2016) High rate of mortality in Spanish community-dwelling population aged 85 with atrial fibrillation after three years of follow-up: the Octabaix study. Australas J Ageing 35:216–219CrossRefPubMedGoogle Scholar
  12. 12.
    Massó-van Roessel A, Escobar-Robledo LA, Dégano RI et al (2017) Analysis of the association between electrocardiographic p-wave characteristics and atrial fibrillation in the REGICOR study. Rev Esp Cardiol (Engl Ed) 70:841–847CrossRefGoogle Scholar

Copyright information

© European Geriatric Medicine Society 2018

Authors and Affiliations

  • Francesc Formiga
    • 1
  • Carmen Guerrero
    • 2
  • Assumpta Ferrer
    • 3
  • Gloria Padrós
    • 4
  • Albert Ariza
    • 2
  1. 1.Geriatric Unit, Internal Medicine Department, Bellvitge Biomedical Research Institute, IDIBELLHospital Universitari de BellvitgeL’Hospitalet de LlobregatSpain
  2. 2.Cardiology Service, Bellvitge Biomedical Research Institute, IDIBELLHospital Universitari de BellvitgeL’Hospitalet de LlobregatSpain
  3. 3.Primary Care Centre “El Plà”, Direcció d’Atenció Primària Costa de PonentInstitut Català de la SalutSant Feliu de LlobregatSpain
  4. 4.South Metropolitan Clinical Laboratory, Direcció d’Atenció Primària Costa de PonentInstitut Català de la SalutL’Hospitalet de LlobregatSpain

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