Document Detail

Interatrial block: pandemic prevalence concealed by anachronistic electrocardiographic standards.
MedLine Citation:
PMID:  16144214     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Interatrial block (IAB; P waves 2 > or =110 ms duration) has been reported in over 40% of unselected patients in sinus rhythm at widely separated general hospitals. It is thus of "pandemic" proportions. It should be better appreciated because it represents a large, baggy, poorly functional left atrium and is a forerunner of atrial fibrillation, atrial flutter, and other arrhythmias. HYPOTHESIS: A search of all 12 leads will disclose the true prevalence of IAB in contrast to traditional reliance on lead II, as widely proposed in textbooks and other literature. METHODS: In all, 500 consecutive unselected electrocardiograms (ECGs) were investigated using every lead and a magnifying graticule. For greater specificity, a minimal P duration of > or =120 ms was selected. RESULTS: Thirty-one ECGs were discarded because of atrial arrhythmia, poor baseline, or undetectable P waves, leaving a base of 469 ECGs, the denominator for the results. A total of 182 patients had IAB, representing 38.8% of this series. The widest P wave was usually found in multiple leads (95.1% of patients). The widest P waves were found only in precordial leads in 59 patients and only in limb leads in 18 patients. "Traditional" lead II detected only 97 cases (53.3%), and IAB was found more frequently in leads V3 and V4. CONCLUSIONS: Results confirm the pandemic frequency of IAB in one-third of hospitalized patients. Interpreters of ECGs should seek IAB in all 12 leads since reliance on lead II alone resulted in only 53.3% of the total cases. Its prevalence and serious implications with regard to patients' current and future status make this necessary.
Mary E Frisella; Michelle M Robinette; David H Spodick
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical cardiology     Volume:  28     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-09-07     Completed Date:  2005-12-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  381-3     Citation Subset:  IM    
Cardiovascular Division, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
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MeSH Terms
Heart Block / diagnosis*,  epidemiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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