The Management of Supraventricular Tachyarrhythmias in Patients with Pulmonary Arterial Hypertension

Małaczyńska-Rajpold, Katarzyna; Komosa, Anna; Błaszyk, Krzysztof; Araszkiewicz, Aleksander; Janus, Magdalena; Olasińska-Wiśniewska, Anna; Jankiewicz, Stanisław; Mączyński, Maciej; Mularek‐Kubzdela, Tatiana

doi:10.1016/j.hlc.2015.10.008

Cited by 31 publications

(49 citation statements)

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“…In the described case, such a reduction of right atrial pressure and sympathetic overactivity by the means of BAS [6] not only fulfilled the abovementioned role, but also showed another benefit -a relief from atrial tachycardia, which improved the patient's short-term prognosis [2,3]. …”

Section: Balloon Atrial Septostomy In Pulmonarymentioning

confidence: 61%

“…1C); in right heart catheterization: mean pulmonary artery pressure -43 mm Hg, mean right atrial pressure -24 mm Hg, cardiac index -1.6 L/min/m 2 , blood oxygen saturation in pulmonary artery -59.6%, pulmonary resistance -19 WU. We considered next RF ablation procedure to stop the arrhythmia, but there was a strong suspicion that the arrhythmia is rather a result than a cause of the patient's clinical deterioration [2,3]. Therefore we performed balloon atrial septostomy (BAS) to decrease right ventricle preload (Fig.…”

Section: Balloon Atrial Septostomy In Pulmonarymentioning

confidence: 99%

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Balloon atrial septostomy in pulmonary arterial hypertension: A beneficial effect on the control of rhythm abnormalities

2016

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Section: Balloon Atrial Septostomy In Pulmonarymentioning

confidence: 61%

Section: Balloon Atrial Septostomy In Pulmonarymentioning

confidence: 99%

Balloon atrial septostomy in pulmonary arterial hypertension: A beneficial effect on the control of rhythm abnormalities

2016

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“…Self limiting episodes of arrhythmias may have been missed. It is noteworthy that TAPSE was reduced, 7,8,13 and BNP, 12,13 right atrial area, 7,8,10,13 and mean right atrial pressure 7,8,10,13 were elevated in patients with arrhythmias. In Olsson and colleagues' study, all patients had normal left atrial dimensions 12 ; in Rottlaender and colleagues' study, in patients without group 2 PH, elevated right atrial pressure and right atrial dilatation were associated with Afib 13 and seemed to be responsible for it.…”

Section: Discussionmentioning

confidence: 97%

“…Incidence of supraventricular arrhythmias varied between 7.8% and 35% [7][8][9][10][11][12][13][14][15] ; reasons for this difference remain unclear. Age does not seem to be a reason, because in the authors' study, 7 patients were older and had lower incidence of arrhythmias than in other studies, [8][9][10][11][12][13][14][15] despite it being well-known that prevalance of AFib increases with age. 19 Patients underwent (only) repeated twelve-lead ECGs in all studies during follow up.…”

Section: Discussionmentioning

confidence: 99%

“…During follow up (n = 137 patients), AFib was detected in 13 patients (53.8% group 1 PH). At the timepoint of baseline ECG, patients were treated with beta-blockers (n = 42), calcium channel blockers (n = 35), and digitalis (n = 13), and a cardiac pacemaker was 8 Seventeen patients suffered from arrhythmias like AFib (n = 8), atrial tachycardia (AT, n = 6), and atrial flutter (AFlu, n = 6). Four patients had more than one type of tachyarrhythmia.…”

Section: Supraventricular Arrhythmiasmentioning

confidence: 99%

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Arrhythmias in Patients With Pulmonary Hypertension; A Narrative Review of the Current Literature

Bandorski

Hoeltgen²

2018

Hosp Pract Res

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Background Pulmonary hypertension (PH) is defined as an increase in the mean pulmonary pressure (mPAP) >25 mm Hg at rest and capillary wedge pressure (PCWP) <15 mm Hg in precapillary (group 1, 3-5) or >15 mm Hg in postcapillary (group 2) forms. 1 Proliferation of pulmonary artery smooth muscle and endothelial cells, endothelial dysfunction, inflammation and excessive vasoconstriction lead to arteriolar obstruction, elevated pulmonary arterial pressure, and increased pulmonary vascular resistance (PVR). 2,3 Increased PVR causes elevated afterload of the right ventricle and cardiac remodelling. 4 Elevated rightsided filling pressure and cardiac remodelling could provide the substrate or trigger for arrhythmias. 5,6 Several studies have evaluated the incidence of supraventricular and ventricular arrhythmias and their prognostical relevance in patients with PH. 7-15 It is already known that supraventricular arrhythmias are associated with clinical deterioration, but the incidence of sudden cardiac death was not elevated in these patients. 8,10,12,14,15 The incidence and clinical/prognostical relevance of non-sustained ventricular tachycardia was analyzed in only three studies. 16-18 2. Objective The aim of this review is to give an actual and comprehensive overview of the current literature with respect to incidence and clinical and prognostical relevance of arrhythmias in patients with PH. 3. Methods This review summarized the current evidence from the literature. Studies indexed (until 20/11/2017) in Medline and published in English or German that investigated patients in all PH groups (1-5) were considered. Medline searches included the following keywords:

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Radiofrequency catheter ablation for pulmonary hypertension patients with atrial flutter

Zhang,

Ding,

Zhang

et al. 2024

ESC Heart Failure

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AimsWe aimed to evaluate the effects of radiofrequency catheter ablation (RFCA) and the factors influencing mortality after RFCA in patients with pulmonary hypertension (PH) and atrial flutter (AFL).Methods and resultsFifty‐eight consecutive PH patients with AFL who underwent an electrophysiological study and RFCA between April 2013 and August 2021 were selected for this study. In the study population, pulmonary arterial hypertension associated with congenital heart disease (PAH‐CHD) was the most common type of PH (n = 34, 59%), followed by idiopathic pulmonary arterial hypertension (IPAH) (n = 19, 33%). Typical atrial flutter was the most common type of atrial flutter (n = 50, 86.2%). Sinus rhythm was restored in 53 (91.4%) patients during RFCA. After a mean follow‐up of 33.8 months, AFL recurred in a total of 22 patients. Nine of them underwent repeat RFCA, and the site of the repeat ablation was not exactly the same as the first. At a median follow‐up of 34.6 months after the last ablation, none of the patients who underwent repeat RFCA experienced AFL recurrence, and all of these patients survived. There were no procedure‐related complications during hospitalization or follow‐up. Univariate Cox regression analysis suggested that AFL recurrence after the last ablation was not associated with all‐cause mortality. NT‐proBNP (HR: 1.00024, 95% CI: 1.00008–1.00041, P = 0.004), pulmonary artery systolic pressure (PASP) (HR: 1.048, 95% CI: 1.020–1.076, P = 0.001), and IPAH (vs. PAH‐CHD, HR: 7.720, 95% CI: 1.437–41.483, P = 0.017) were independent predictors of all‐cause mortality in PH patients with AFL after RFCA. Receiver operating characteristic (ROC) curve analysis revealed that the area under the curve (AUC) of PASP for predicting all‐cause mortality was 0.708. There was no significant difference in the Kaplan–Meier curves for all‐cause mortality between patients with AFL recurrence after the last ablation and those without recurrence (P = 0.851). Patients with higher PASP (≥110 mmHg) and IPAH showed the lower survival rate in Kaplan–Meier curves.ConclusionRepeat ablation was safe and feasible in patients with recurrent AFL and can maintain sinus rhythm. AFL recurrence was not associated with all‐cause mortality, and patients with high PASP or IPAH were at higher risk for adverse outcomes.

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The Management of Supraventricular Tachyarrhythmias in Patients with Pulmonary Arterial Hypertension

Cited by 31 publications

References 9 publications

Balloon atrial septostomy in pulmonary arterial hypertension: A beneficial effect on the control of rhythm abnormalities

Balloon atrial septostomy in pulmonary arterial hypertension: A beneficial effect on the control of rhythm abnormalities

Arrhythmias in Patients With Pulmonary Hypertension; A Narrative Review of the Current Literature

Radiofrequency catheter ablation for pulmonary hypertension patients with atrial flutter

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