The presence of an interatrial block (IAB) on surface ECG should be considered as a hallmark of atrial electrical remodelling. This is often accompanied by morphological abnormalities. We aimed to investigate the frequency of IAB and its relationship with the echocardiographic indices of left atrial (LA) remodelling in patients hospitalised with acute HF. Ninety-four consecutive HF patients underwent 12-lead ECG, transthoracic echocardiogram including a detailed study of the LA, and blood tests (including NT-proBNP) on the same day. Thirty-six patients were excluded from the analysis because of atrial fibrillation or rhythms other than sinus. Twenty-eight over 58 (48%) were males. Median age was 72 (IQR 60–82) years. The majority of patients (72%) were diagnosed as having an HF with reduced ejection fraction. Overall, 27 (46%) patients presented with an advanced III or IV NYHA functional class. Median plasma NT-proBNP was 3046 (IQR 1066–5460) pg/ml. Nearly, all the enrolled patients (90%) showed LA dilation. Nineteen patients (33%) presented with advanced IAB. There was a trend toward a more advanced age in patients with advanced IAB (median age 79 vs 68, p = 0.051). Moreover, they were more frequently treated with anticoagulants (42% vs 13%, p = 0.01), and they exhibited greater LA structural and functional remodelling documented by larger area (28 vs 26 cm², p = 0.04) and greater minimum LA volume index—LAVi (43 ± 16 vs 36 ± 10, p = 0.04). Advanced IAB resulted to be an independent determinant of LA area (Beta 3.49 (0.37–6.60), p = 0.03) and minimum LAVi (Beta 7.22 (0.15–14.30), p = 0.045), and vice versa. LA electrical and structural remodelling is highly prevalent in a non-selected cohort of patients with acute HF. Advanced IAB on surface ECG is present in a high percentage of cases. Patients with advanced IAB tend to be older, and they exhibit higher degrees of LA structural and functional remodelling.

表面心电图上存在心房传导阻滞 (IAB) 应被视为心房电重构的标志。这通常伴有形态异常。我们旨在调查急性 HF 住院患者 IAB 的频率及其与左心房 (LA) 重塑的超声心动图指标的关系。94 名连续 HF 患者在同一天接受了 12 导联心电图、经胸超声心动图（包括对 LA 的详细研究）和血液检查（包括 NT-proBNP）。由于心房颤动或除窦性以外的节律，36 名患者被排除在分析之外。58 岁以上的 28 人（48%）是男性。中位年龄为 72 (IQR 60-82) 岁。大多数患者 (72%) 被诊断为射血分数降低的 HF。全面的，27 名 (46%) 患者出现晚期 III 或 IV NYHA 功能分级。血浆 NT-proBNP 中位数为 3046 (IQR 1066–5460) pg/ml。几乎所有入组患者 (90%) 均出现 LA 扩张。19 名患者 (33%) 出现晚期 IAB。晚期 IAB 患者的年龄趋向于更高龄（中位年龄 79 岁 vs 68 岁，p  = 0.051)。此外，他们更频繁地接受抗凝剂治疗（42% 对 13%，p  = 0.01），并且他们表现出更大的 LA 结构和功能重塑，记录的面积更大（28 对 26 cm ²，p  = 0.04）和更大的最小 LA 体积指数——LAVi (43 ± 16 vs 36 ± 10, p  = 0.04)。高级 IAB 是 LA 面积 (Beta 3.49 (0.37–6.60), p  = 0.03) 和最小 LAVi (Beta 7.22 (0.15–14.30), p = 0.045)，反之亦然。LA 电和结构重塑在非选定的急性 HF 患者队列中非常普遍。表面心电图上的高级 IAB 存在于高比例的病例中。晚期 IAB 患者往往年龄较大，他们表现出更高程度的 LA 结构和功能重塑。