First-degree atrioventricular block in patients with atrial fibrillation and atrial flutter: the prevalence of intra-atrial conduction delay.

Spies, Florian; Knecht, Sven; Zeljkovic, Ivan; Reichlin, Tobias; Madaffari, Antonio; Osswald, Stefan; Sticherling, Christian; Kühne, Michael (2021). First-degree atrioventricular block in patients with atrial fibrillation and atrial flutter: the prevalence of intra-atrial conduction delay. Journal of interventional cardiac electrophysiology, 61(2), pp. 421-425. Springer 10.1007/s10840-020-00838-3

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PURPOSE

PR interval prolongation > 200 ms resulting in the diagnosis of first-degree atrioventricular block (AVB1) is caused by a delay in the AV nodal/His conduction and/or the right intra-atrial conduction (RIAC). The aim of the study was to assess the prevalence of AVB1 due to RIAC delay (AVB1 with normal AH and HV) in patients with atrial fibrillation (AF) and atrial flutter (AFlu).

METHODS

We included 1067 consecutive patients (33% female, age 63 ± 13 years) referred for catheter ablation of AF (AF-group) (453 patients), AF and AFlu (136 patients), AFlu (292 patients), and AVNRT/AVRT (186 patients). AH-, HV-, PR-interval, and P-wave duration were measured on the 12-lead ECG and the intracardiac electrograms in sinus rhythm. RIAC delay was defined as a prolonged PR interval > 200 ms with normal AH and HV intervals.

RESULTS

The prevalence of AVB1 is higher in patients with AFlu (41%) and AF (21%) and patients with both arrhythmias (30%) as compared with a reference group (8%) of patients with AVNRT/AVRT. AVB1 was due to RIAC delay in 42 of 67 patients (63%) in the AF-group, in 37 of 96 patients (39%) in the AFlu-group, and in 17 of 36 patients (47%) in the AF/AFlu group, respectively. AV nodal conduction delay was more common in AFlu patients compared with AF patients.

CONCLUSION

RIAC delay is a common underlying cause of AVB1 in patients with AF and AFlu. These findings may impact the prescription of antiarrhythmic and AV-nodal blocking drugs.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Reichlin, Tobias Roman

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1383-875X

Publisher:

Springer

Language:

English

Submitter:

Daria Vogelsang

Date Deposited:

30 Nov 2020 10:08

Last Modified:

05 Dec 2022 15:41

Publisher DOI:

10.1007/s10840-020-00838-3

PubMed ID:

32734408

Uncontrolled Keywords:

Atrial fibrillation Atrial flutter First degree atrioventricular block HV interval Intra-atrial conduction delay

BORIS DOI:

10.7892/boris.147594

URI:

https://boris.unibe.ch/id/eprint/147594

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