![]() In addition, patients undergoing catheter ablation of AVNRT or AVRT were analyzed as a reference group representing patients without any known or suspected right atrial myocardial conduction disease. The aim of this study was to assess the prevalence of AVB1 due to RIAC delay by standard invasive electrophysiological measurements in patients referred for catheter ablation of AF and AFlu. Furthermore, the prevalence of RIAC delay defined as AVB1 with normal AH and HV intervals is unknown. The exact contribution of the RIAC interval on the PR interval commonly used for electrical characterization of the heart has not been systematically investigated in patients with AF and AFlu. The electrical and structural remodeling of the atrium observed in patients with AF and cavotricuspid isthmus (CTI)-dependent AFlu may result in (right) atrial conduction delay influencing the PR interval measurements. Since the PR interval is measured between the onset of the P wave and of the QRS-complex on the 12-lead ECG, it is dependent on both, the right intra-atrial conduction (RIAC) and the AV conduction over the AV node and the His bundle. These findings may impact the prescription of antiarrhythmic and AV-nodal blocking drugs.įirst-degree atrioventricular block (AVB1), defined as PR interval longer than 200 ms, is frequently encountered in clinical practice and generally considered benign. RIAC delay is a common underlying cause of AVB1 in patients with AF and AFlu. AV nodal conduction delay was more common in AFlu patients compared with AF patients. 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. 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. RIAC delay was defined as a prolonged PR interval > 200 ms with normal AH and HV intervals. AH-, HV-, PR-interval, and P-wave duration were measured on the 12-lead ECG and the intracardiac electrograms in sinus rhythm. ![]() 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). ![]() 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). 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). ![]()
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