Potential clinical correlates and risk factors for interatrial block

Abstract

Background: Interatrial block (IAB; P wave > or =110 ms) denotes a conduction delay between the atria, is strongly associated with atrial tachyarrhythmias, left atrial enlargement, left atrial electromechanical dysfunction, and is a risk for embolism. Despite this, potential risk factors for IAB have not been clearly defined.

Methods: Patients admitted via the Emergency Department for nonacute medical reasons to the nontelemetry general medical floors of a tertiary care general hospital from October to November 2004 were screened for sinus rhythm on electrocardiograms. Four hundred and four patients who met our criteria were then evaluated for IAB on respective electrocardiograms. All patients were subsequently compared for common diseases as well as coronary artery disease (CAD) risk factors and divided into two groups, those with IAB and those without (control). Mean age +/- standard deviation, odds ratios (ORs), 95% confidence intervals (CIs), r values, and p values were calculated. p values <0.05 were considered statistically significant.

Results: From the sample (n = 404), 182 patients had IAB (45%; mean age 64.32 +/- 19.27 years; males 51.6%) while 222 did not (control). CAD (OR 3.150, 95% CI 2.05-4.83; p < 0.001, r = 0.3), hypertension (OR 2.918, 95% CI 1.85-4.60; p < 0.001, r = 0.2), diabetes mellitus (OR 2.542, 95% CI 1.62-3.97; p < 0.001, r = 0.1), and hypercholesterolemia (OR 1.823, 95% CI 1.22-2.74; p = 0.004, r = 0.2) were significant risk factors and correlates for IAB. Multivariate analysis using stepwise linear regression revealed these factors as direct correlates of IAB.

Conclusion: CAD, hypertension, diabetes mellitus and hypercholesterolemia appear to be risk factors for IAB in general hospital patients admitted for nonacute reasons. Considering the known sequelae of IAB, awareness of its associations with such risk factors could be important for patient risk stratification.