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This study evaluated the correlation between interatrial block (IAB) and atrial fibrillation (AF) among patients admitted to our Internal Medicine Unit: 110 (group 1) were identified with electrocardiograms both in sinus rhythm and AF, and 123 (group 2) constantly in sinus rhythm. In both we analyzed: the presence of partial (P≥120 msec) or advanced (P>120 msec and biphasic in D2, D3, aVF) IAB, and the main electrocardiographic and clinical features. Age and gender between the two groups were similar. IAB was present in 89/110 (80.91%,) in group 1 and 26/123 (21.13%) in group 2 (P=<0.01); partial in 50/110 (45.45%) and 19/123 (15.7%) in group 1 and 2 respectively (P<0.01), advanced in 39/110 (35.45%) and 7/123 (5.69%) (P<0.019). The correlation between IAB and AF was significant (P<0.001); out of 55 patients with atrial echo dilatation 36 (65.4%) had IAB and 14 (25.4%) had deep terminal negativity of P-wave in V1 (DTNPV1) >0.1 mV (P<0.01). IAB represents a reliable predictor of AF; moreover, the sensitivity of the IAB in detecting atrial dilatation is higher than the DTNPV1 >0.1 mV.