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Juan Jose Martinez Rivas

University Los Andes, Venezuela

Title: The value of “P”: Novel risk factors for ischemic stroke?

Biography

Biography: Juan Jose Martinez Rivas

Abstract

Introduction: The interatrial block (IAB) is a delay in atrial conduction defined as a wide p-wave (wpw) on electrocardiogram (ECG) but has low specificity for supraventricular tachycardia (SVA) and ischemic stroke (IS) prediction. New criteria for IAB appeared as the biphasic morphology of p wave in the inferior leads, which has increased its predictive value. The objective of this study is to find relationship between new IAB’s criteria (NIAB) and IS of undetermined cause (ISUC).

Method: retrospective study of 188 cases admitted to hospital for ISUC (A group) without prior arrhythmias, compared to 180 controls admitted for other causes (B group). NIAB finding on the ECG (biphasic p≥120ms in II, III and AVF) was assessed in both groups. Data analysis was made to find IAB differences between groups in relation to age (<75; ≥75) and comorbidities.

Results: 368 patients (47% women; mean age 72,7+15,2; Barthel index 79,5+24,9) were included. wpw and NIAB findings were significantly more prevalent in A group (p≤0.000), with no other differences observed. Significant differences were found considering age: stronger association wpw-IS vs NIAB-IS in the youngest group (OR 24,1(12,4-46,7) vs 20,5(4,8-87,3) in contrast with a stronger association NIAB-IS vs wpw-IS in the oldest group (OR 33,8(4,3-264,7 vs 7,4(2,1-26,8).

Conclusions: wpw and NIAB were significantly related to ISUC. Relevant differences were found considering age, being more prevalent the presence of wpw in younger with IS of UC and NIAB in elder. Although more studies are needed, these outcomes could justify primary prophylaxis with anticoagulation before SVA appears.