{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T05:07:52Z","timestamp":1781586472664,"version":"3.54.5"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,10,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Interatrial block (IAB) in an ECG, manifesting atrial pathology, is a possible risk factor for atrial arrhythmias and ischemic stroke. IAB is often transiently expressed, posing a major challenge for risk estimation when only a limited number of ECGs are available.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">This is a retrospective study of 9674 consecutive patients diagnosed with acute coronary syndrome (ACS) between 2007 and 2018. All standard ECGs registered between January 2007 and March 2023 (n=206\u2009668) were digitally stored and analyzed using the General Electric Marquette 12SL algorithm for the presence of an IAB, atrial fibrillation, and atrial flutter. The population was stratified by the extent of the IAB, and patients without an IAB served as controls. Clinical phenotype data and end point data for ischemic stroke were collected by a full disclosure review of hospital records and death certificate data including written accounts of deaths.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      The prevalence of an advanced IAB was 8.5% if all previous ECGs, including those recorded during ACS, were screened, whereas it was only 2.4% during ACS. The risk of atrial fibrillation\/atrial flutter after ACS increased with the severity of the IAB, and the highest risk was attributable to advanced IAB (age\u2010 and sex\u2010adjusted hazard ratio [HR], 2.87 [95% CI, 2.48\u20133.32];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.00001; and fully risk\u2010factor adjusted [including left ventricular ejection fraction] HR, 2.22 [95% CI, 1.89\u20132.62];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.00001). Advanced IAB was also associated with an almost 2\u2010fold risk of ischemic stroke if adjusted for the CHA\n                      <jats:sub>2<\/jats:sub>\n                      DS\n                      <jats:sub>2<\/jats:sub>\n                      \u2010VASc score (HR, 1.95 [95% CI, 1.47\u20132.58];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.00001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Automatic detection of an IAB from serial ECGs reveals a strong association between atrial pathology and the risk of atrial fibrillation, atrial flutter, and ischemic stroke in patients with ACS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.041313","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T12:11:42Z","timestamp":1760011902000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Interatrial Block Detected by a Series of ECGs Before and During Acute Coronary Syndrome Predicts Atrial Fibrillation, Atrial Flutter, and Ischemic Stroke"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-4173-3480","authenticated-orcid":false,"given":"Ville","family":"Aarnivala","sequence":"first","affiliation":[{"name":"Tampere University","place":["Tampere, Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3743-4887","authenticated-orcid":false,"given":"Tiia","family":"Istolahti","sequence":"additional","affiliation":[{"name":"Tays Heart Hospital, Department of Cardiology, Tampere University Hospital","place":["Tampere, Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matilda","family":"Hurskainen","sequence":"additional","affiliation":[{"name":"Tampere University","place":["Tampere, Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juho","family":"Tynkkynen","sequence":"additional","affiliation":[{"name":"Tays Heart Hospital, Department of Cardiology, Tampere University Hospital","place":["Tampere, Finland"]},{"name":"Tampere University Hospital","place":["Tampere, Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Pohjant\u00e4hti","sequence":"additional","affiliation":[{"name":"Tampere University","place":["Tampere, Finland"]},{"name":"Tays Heart Hospital, Department of Cardiology, Tampere University Hospital","place":["Tampere, Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7200-5455","authenticated-orcid":false,"given":"Leo\u2010Pekka","family":"Lyytik\u00e4inen","sequence":"additional","affiliation":[{"name":"Tampere University","place":["Tampere, Finland"]},{"name":"Tays Heart Hospital, Department of Cardiology, Tampere University Hospital","place":["Tampere, Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9345-9851","authenticated-orcid":false,"given":"Kjell","family":"Nikus","sequence":"additional","affiliation":[{"name":"Tampere University","place":["Tampere, Finland"]},{"name":"Tays Heart Hospital, Department of Cardiology, Tampere University Hospital","place":["Tampere, Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8111-6421","authenticated-orcid":false,"given":"Jussi","family":"Hernesniemi","sequence":"additional","affiliation":[{"name":"Tampere University","place":["Tampere, Finland"]},{"name":"Tays Heart Hospital, Department of Cardiology, Tampere University Hospital","place":["Tampere, 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