Copyright © 1988 by the European Society of Cardiology.
© 1988 The European Society of Cardiology
Interatrial conduction block and retrograde activation of the left atrium and paroxysmal supraventricular tachyarrhythmia
Servicio de Cardiología Hospital de San Pablo, Departamento de Medicina, Universidad Autónoma de Barcelona Spain
Received 17 November 1987; revised 8 April 1988; .
Address for correspondence and reprints Dr A. Bayés de Luna. Servicio de Cardiologia, Hospital de San Pablo, San Antonio Maria Claret no. 167. 08025 Barcelona, Spain.
Abstract
We studied 16 patients with electrocardiographic evidence of advanced interatrial block and retrograde activation of the left atrium (P
0.12 s, and diphasic (±) P waves in leads II, III, and VF). Eight patients had valvular heart disease, four had dilated cardiomyopathy and four had other forms of heart disease. Patients with valvular heart disease and cardiomyopathy were compared with a control group of 22 patients with similar clinical and echocardiographic characteristics, but without this type of interatrial block.
Patients with advanced interatrial block and retrograde activation of the left atrium had a much higher incidence of paroxysmal supraventricular tachyarrhythmias (93.7%) during follow-up than did the control group, (27.7%) (P>0.001). Eleven of 16 patients (68.7%) with advanced interatrial block and retrograde activation of left atrium had atrial flutter (atypical in seven cases, typical in two cases, and with two or more morphologies in two cases). Six patients from the control group (27.7%) had sustained atrial tachyarrhythmias (five atrial fibrillation and one typical atrial flutter). The atrial tachyarrhythmias were due more to advanced interatrial block and retrograde activation of left atrium and frequent atrial extrasystoles than to left atrial enlargement, because the control group with a left atrium of the same size, but without advanced interatrial block and retrograde activation of left atrium and with less incidence of atrial extrasystoles, had a much lower incidence of paroxysmal tachycardia.
Key Words: Interatrial block • atrial tachyarrhythmias
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