Cardiovascular Complications of Interatrial Conduction Block: JACC State-of-the-Art Review

J Am Coll Cardiol. 2022 Mar 29;79(12):1199-1211. doi: 10.1016/j.jacc.2022.01.030.

Abstract

Interatrial block (IAB) is an electrocardiographic pattern describing the conduction delay between the right and left atria. IAB is classified into 3 degrees of block that correspond to decreasing conduction in the region of Bachmann's bundle. Although initially considered benign in nature, specific subsets of IAB have been associated with atrial arrhythmias, elevated thromboembolic stroke risk, cognitive impairment, and mortality. As the pathophysiologic relationships between IAB and stroke are reinforced, investigation has now turned to the potential benefit of early detection, atrial imaging, cardiovascular risk factor modification, antiarrhythmic pharmacotherapy, and stroke prevention with oral anticoagulation. This review provides a contemporary overview of the epidemiology, pathophysiology, diagnosis, and management of IAB, with a focus on future directions.

Keywords: IAB; anticoagulation; atrial fibrillation; interatrial block; state-of-the-art review.

Publication types

  • Review

MeSH terms

  • Atrial Fibrillation* / complications
  • Electrocardiography / methods
  • Heart Atria / diagnostic imaging
  • Heart Block / diagnosis
  • Heart Block / epidemiology
  • Heart Block / etiology
  • Humans
  • Interatrial Block / complications
  • Interatrial Block / diagnosis
  • Interatrial Block / epidemiology
  • Stroke* / epidemiology
  • Stroke* / etiology
  • Stroke* / prevention & control