Bayés syndrome and acute cardioembolic ischemic stroke

Abstract

Bayés syndrome is an under-recognized clinical condition characterized by advanced interatrial block. Bayés syndrome is a subclinical disease that manifests electrocardiographically as a prolonged P wave duration > 120 ms with biphasic morphology ± in the inferior leads. The clinical relevance of Bayés syndrome lies in the fact that is a clear arrhythmological syndrome and has a strong association with supraventricular arrhythmias, particularly atypical atrial flutter and atrial fibrillation. Likewise, Bayés syndrome has been recently identified as a novel risk factor for non-lacunar cardioembolic ischemic stroke and vascular dementia. Advanced interatrial block can be a risk for embolic stroke due to its known sequelae of left atrial dilation, left atrial electromechanical dysfunction or atrial tachyarrhythmia (paroxysmal or persistent atrial fibrillation), conditions predisposing to thromboembolism. Bayés syndrome may be responsible for some of the unexplained ischemic strokes and shall be considered and investigated as a possible cause for cryptogenetic stroke. In summary, Bayés syndrome is a poorly recognized cardiac rhythm disorder with important cardiologic and neurologic implications.

Keywords: Bayés syndrome; Cardioembolic stroke; Electrophysiological processes; Cardiovascular risk factors; Heart conduction system

Core tip: Bayés syndrome is an under-recognized cardiac rhythm disorder with significant cardiologic and neurologic implications. It constitutes a genuine arrhythmological syndrome characterized by advanced interatrial block. Bayés syndrome is a key predictor of higher risk of new-onset atrial fibrillation and it is independently associated with an increased risk for non-lacunar cardioembolic stroke. Likewise, can be the cause of some cryptogenic strokes, and be related to clinically silent cerebral ischemia and vascular cognitive impairment, or even, vascular dementia.