Advanced Interatrial Block is Associated with Recurrence of Atrial Fibrillation Post Pharmacological Cardioversion
Bibliographic record
Abstract
INTRODUCTION: Management of atrial fibrillation (AF) is hampered by frequent recurrences after restoration of sinus rhythm. Delayed interatrial conduction has been associated with the development of AF in different clinical settings. The aim of our study was to assess whether advanced interatrial block (aIAB) was associated with AF recurrence after pharmacological cardioversion with two different antiarrhythmic drugs. METHODS: We included 61 patients with recent onset AF without structural heart disease that underwent successful pharmacological cardioversion. Thirty-one patients received a single oral dose of propafenone, and 30 patients received iv vernakalant. A 12-lead ECG (filter 150 Hz, 25 mm/s, 10 mm/mV) after conversion was evaluated for the presence of interatrial block (IAB); partial (pIAB): P-wave duration > 120 ms, and advanced (aIAB): P-wave > 120 ms and biphasic morphology (±) in inferior leads. Clinical follow-up and electrocardiographic recordings were performed for a 12-month period. RESULTS: Age was 58 ± 10.4 years and 50.8% were male. aIAB was present in 11 patients (18%) and pIAB in 10 (16.4%). At 1-year follow-up, 22 patients (36%) had AF recurrence. The recurrence rate with aIAB was 90.9% versus 70% in those with pIAB and 12.5% in normal P-wave duration (P = 0.001). The presence of aIAB was strongly associated with AF recurrence (odds ratio 18.4 in multivariable modeling). Recurrence was not affected by the drug used for cardioversion (P = 0.92). CONCLUSION: Advanced interatrial block is associated with higher risk of AF recurrence at 1 year after pharmacological cardioversion, independent of the drug used.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".