Arrhythmias in Primary Pulmonary Hypertension

Abstract

Through the examination of 171 electrocardiograms (ECG) of 101 patients with primary pulmonary hypertension (PPH), the following conclusions were obtained. Arrhythmias were found in 27 (26.7%) of the 101 patients. Among the surviving cases, arrhythmias were found in 8 (17.8%) out of 45 patients, but among the deceased cases, the figure was higher, 19 (33.9%) out of 56. There were instances of more than one kind of arrhythmias in the same patient and a total of 34 types of arrhythmias were noted. The main types of arrhythmias were sinus tachycardia (13 cases), sinus bradycardia (6 cases), and first degree A-V block (5 cases), which accounted for 70% of the total. Sinus tachycardia was observed in only 2 of the survivors but in 11 of the deceased cases, which showed a significant difference (p<0.05). First degree A-V block were all induced by digitalis. Wenckebach type of second degree A-V block was noted in only 1 case and it was also induced by digitalis. Since severe attacks of ventricular arrhythmias were very rare in these cases with PPH, it is difficult to consider the Adams-Stokes syndrome as the cause of syncopal attacks or sudden death. However, it is necessary to further investigate nodal functions by means of continuous ECG monitoring, the overdrive suppression test and His bundle ECGs.

Predictive value of P-wave and QT interval dispersion in children with congenital heart disease and pulmonary arterial hypertension for the occurrence of arrhythmias

“…No arrhythmias were detected in Group II and Control group. In accordance with our results, the most common arrhythmias detected in patients with PAH were found to be sinus tachycardia, sinus bradycardia, SVT, atrial flutter, and AF, whereas the ventricular arrhythmias were relatively rare [17], [18].…”

Arrhythmias in pulmonary arterial hypertension

“…Studies looking at arrhythmias in PAH have defined the incidence and prevalence of arrhythmias in a population of patients PAH but have not made a comparison with a matched cohort of apparently healthy individuals [8,16]. The incidence and prevalence of arrhythmias quoted from studies of the general population are not age and sex matched with studies of patients with PAH and may include people with other cardiac comorbidities [17,18].…”

Arrhythmias in Pulmonary Arterial Hypertension

“…In 1962, James described the postmortem findings of sinoatrial and atrioventricular nodal artery disease in three patients with severe PAH and syncope who died suddenly (4). In 1979, Kanemoto et al examined ECGs from patients with PAH and found that sinus tachycardia, sinus bradycardia and first degree A-V block occurred in 70% of the patients, whereas ventricular arrhythmias were rare (5). Although these early studies highlighted the need to investigate the incidence of arrhythmias in this patient population further, there remains a relative paucity of data regarding the incidence, mechanism, prognostic significance, and treatment of arrhythmias in patients with PAH.…”