Abstract
Prediction and early detection of atrial fibrillation (AF) remain a permanent challenge in everyday practice. Timely identification of an increased risk for AF episodes (which are frequently asymptomatic) is essential in the primary and secondary prevention of cardioembolic events. One of the noninvasive modalities of AF prediction is represented by the electrocardiographic P-wave analysis. This includes the study and diagnosis of interatrial conduction block (Bachmann’s bundle block). Bayés’ Syndrome (named after its first descriptor) denotes the association between interatrial conduction defect and supraventricular arrhythmias (mainly AF) predisposing to cardioembolic events. Our short review presents an update of the most important data concerning this syndrome: brief history, main ECG features, pathophysiological background and clinical implications.
Highlights
The estimated prevalence of atrial fibrillation (AF) is 3% in the general, adult population of >20 years old, with greater prevalence in the elderly and in patients that are associated with hypertension, heart failure, coronary artery disease, valvular heart disease, obesity, diabetes mellitus and chronic kidney disease
Intra- and interatrial electrical pathways are represented by four bundles: (1) the Bachmann’s bundle (BB), which is the anterior internodal pathway, having a (2) branch which connects the right atrium to the left atrium, (3) the Wenckebach’s bundle, which is the middle internodal tract, and (4) the Thorel’s bundle, which represents the posterior internodal pathway [10]
The electrophysiological background of advanced interatrial conduction block (IAB) is thought to be a situation when a sinus impulse can no longer pass via the Bachmann region, instead, it propagates towards the AV node depolarizing the right atrium, the left atrium is depolarized in a caudocranial direction starting from the inferior left atrium, near the atrioventricular node
Summary
The estimated prevalence of atrial fibrillation (AF) is 3% in the general, adult population of >20 years old, with greater prevalence in the elderly and in patients that are associated with hypertension, heart failure, coronary artery disease, valvular heart disease, obesity, diabetes mellitus and chronic kidney disease. Diagnosis requires its documentation using an electrocardiogram (ECG), with irregular RR intervals and no discernible, distinct P waves, by convention during an episode lasting at least 30 s [1]. P-wave dispersion = the difference between the longest and shortest P-wave durations on the standard 12-lead ECG. >80 ms PWSD the standard deviation of the P-wave durations on the standard 12-lead ECG. PACs premature atrial contractions or runs detected mainly on the Holter ECGs presence. Sum of the P-wave and the PR (PQ) interval, involving the atrial depolarization and the conduction via the atrioventricular junction and the.
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