Interatrial Block Predicts Life‐Threatening Arrhythmias in Dilated Cardiomyopathy
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 unknow...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-07-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.121.025473 |
| _version_ | 1797936064812285952 |
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| author | Michiel T. H. M. Henkens Helena López Martínez Jerremy Weerts Arjan Sammani Anne G. Raafs Job A. J. Verdonschot Rutger R. van de Leur Maurits A. Sikking Sophia Stroeks Vanessa P. M. van Empel Hans‐Peter Brunner‐La Rocca Antonius M. W. van Stipdonk Dimitrios Farmakis Mark R. Hazebroek Kevin Vernooy Antoni Bayés‐de‐Luna Folkert W. Asselbergs Antoni Bayés‐Genís Stephane R. B. Heymans |
| author_facet | Michiel T. H. M. Henkens Helena López Martínez Jerremy Weerts Arjan Sammani Anne G. Raafs Job A. J. Verdonschot Rutger R. van de Leur Maurits A. Sikking Sophia Stroeks Vanessa P. M. van Empel Hans‐Peter Brunner‐La Rocca Antonius M. W. van Stipdonk Dimitrios Farmakis Mark R. Hazebroek Kevin Vernooy Antoni Bayés‐de‐Luna Folkert W. Asselbergs Antoni Bayés‐Genís Stephane R. B. Heymans |
| author_sort | Michiel T. H. M. Henkens |
| collection | DOAJ |
| description | 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 milliseconds) 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 fibrillation/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. |
| first_indexed | 2024-04-10T18:24:55Z |
| format | Article |
| id | doaj.art-cb4fdebc7223417d8eb115fbd394b9be |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-10T18:24:55Z |
| publishDate | 2022-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-cb4fdebc7223417d8eb115fbd394b9be2023-02-02T06:20:21ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802022-07-01111410.1161/JAHA.121.025473Interatrial Block Predicts Life‐Threatening Arrhythmias in Dilated CardiomyopathyMichiel T. H. M. Henkens0Helena López Martínez1Jerremy Weerts2Arjan Sammani3Anne G. Raafs4Job A. J. Verdonschot5Rutger R. van de Leur6Maurits A. Sikking7Sophia Stroeks8Vanessa P. M. van Empel9Hans‐Peter Brunner‐La Rocca10Antonius M. W. van Stipdonk11Dimitrios Farmakis12Mark R. Hazebroek13Kevin Vernooy14Antoni Bayés‐de‐Luna15Folkert W. Asselbergs16Antoni Bayés‐Genís17Stephane R. B. Heymans18Department of Cardiology, CARIM Maastricht University Medical Centre Maastricht The NetherlandsHospital Universitari Germans Trias i Pujol Barcelona SpainDepartment of Cardiology, CARIM Maastricht University Medical Centre Maastricht The NetherlandsDepartment of Cardiology Division of Heart and Lungs University Medical Center UtrechtUtrecht University Utrecht The NetherlandsDepartment of Cardiology, CARIM Maastricht University Medical Centre Maastricht The NetherlandsDepartment of Cardiology, CARIM Maastricht University Medical Centre Maastricht The NetherlandsDepartment of Cardiology Division of Heart and Lungs University Medical Center UtrechtUtrecht University Utrecht The NetherlandsDepartment of Cardiology, CARIM Maastricht University Medical Centre Maastricht The NetherlandsDepartment of Cardiology, CARIM Maastricht University Medical Centre Maastricht The NetherlandsDepartment of Cardiology, CARIM Maastricht University Medical Centre Maastricht The NetherlandsDepartment of Cardiology, CARIM Maastricht University Medical Centre Maastricht The NetherlandsDepartment of Cardiology, CARIM Maastricht University Medical Centre Maastricht The NetherlandsUniversity of Cyprus Medical School Nicosia CyprusDepartment of Cardiology, CARIM Maastricht University Medical Centre Maastricht The NetherlandsDepartment of Cardiology, CARIM Maastricht University Medical Centre Maastricht The NetherlandsCardiovascular Research Foundation. Cardiovascular ICCC‐ ProgramResearch Institute Hospital de la Santa Creu i Sant PauIIB‐Sant Pau Barcelona SpainDepartment of Cardiology Division of Heart and Lungs University Medical Center UtrechtUtrecht University Utrecht The NetherlandsHospital Universitari Germans Trias i Pujol Barcelona SpainDepartment of Cardiology, CARIM Maastricht University Medical Centre Maastricht The NetherlandsBackground 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 milliseconds) 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 fibrillation/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.https://www.ahajournals.org/doi/10.1161/JAHA.121.025473dilated cardiomyopathyelectrocardiographyinteratrial blocklife‐threatening arrhythmiasnon‐ischemic cardiomyopathysudden cardiac death |
| spellingShingle | Michiel T. H. M. Henkens Helena López Martínez Jerremy Weerts Arjan Sammani Anne G. Raafs Job A. J. Verdonschot Rutger R. van de Leur Maurits A. Sikking Sophia Stroeks Vanessa P. M. van Empel Hans‐Peter Brunner‐La Rocca Antonius M. W. van Stipdonk Dimitrios Farmakis Mark R. Hazebroek Kevin Vernooy Antoni Bayés‐de‐Luna Folkert W. Asselbergs Antoni Bayés‐Genís Stephane R. B. Heymans Interatrial Block Predicts Life‐Threatening Arrhythmias in Dilated Cardiomyopathy Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease dilated cardiomyopathy electrocardiography interatrial block life‐threatening arrhythmias non‐ischemic cardiomyopathy sudden cardiac death |
| title | Interatrial Block Predicts Life‐Threatening Arrhythmias in Dilated Cardiomyopathy |
| title_full | Interatrial Block Predicts Life‐Threatening Arrhythmias in Dilated Cardiomyopathy |
| title_fullStr | Interatrial Block Predicts Life‐Threatening Arrhythmias in Dilated Cardiomyopathy |
| title_full_unstemmed | Interatrial Block Predicts Life‐Threatening Arrhythmias in Dilated Cardiomyopathy |
| title_short | Interatrial Block Predicts Life‐Threatening Arrhythmias in Dilated Cardiomyopathy |
| title_sort | interatrial block predicts life threatening arrhythmias in dilated cardiomyopathy |
| topic | dilated cardiomyopathy electrocardiography interatrial block life‐threatening arrhythmias non‐ischemic cardiomyopathy sudden cardiac death |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.121.025473 |
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