The prevalence of supraventricular arrhythmias with regard to the type and degree of left ventricular hypertrophy in patients with hypertensive heart disease

Abstract

Concentric and eccentric types of left ventricular hypertrophy have a greater impact on the frequency of atrial arrhythmias. In the concentric type the prevalence of supraventricular premature beats correlates with the degree of left ventricular hypertrophy. Patients with moderate and severe concentric and eccentric left ventricular hypertrophy should be always tested using Holter monitoring and bicycle ergometry and treated with the maximum tolerable doses of antihypertensives, particularly with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers.

Influence of the Type and Degree of Left Ventricular Hypertrophy on the Prevalence of Ventricular Arrhythmias in Patients with Hypertensive Heart Disease

“…The majority of our subjects were physically inactive with elevated values of lipids and urea in serum [14].…”

“…Patients were divided into three main groups with regard to LVH type: concentric (relative wall thickness [RWT] ≥ 0.45 and interventricular septum/left ventricular posterior wall [IVS/LVPW] < 1.3), eccentric (diameter LV in systoles > 32 and RWT < 0.45), and asymmetric (IVS/LVPW > 1.3), as in one previous study [13] and our earlier study [14]. RWT was measured at end-diastole as the ratio of twice the thickness of LVPW/LVIDd (left ventricular internal diastolic diameter) [15].…”

Influence of Patern and Degree of Left Ventricular Hypertrophy on Cardiac Arrhythmias

“…Atrial fibrillation associated with atrial dilatation is often observed in patients with hypertension [31]. About 40% of patients have paroxysmal atrial fibrillation or paroxysmal supraventricular tachycardia during Holter monitoring and additional 4% during the exercise test [32]. Until now it is unable to conclude whether any of the LVH types had a greater effect on the appearance of these arrhythmias.…”

“…Until now it is unable to conclude whether any of the LVH types had a greater effect on the appearance of these arrhythmias. The left atrial size significantly positively correlates with left ventricular hypertrophy degree, and it seems that a larger number of supraventricular premature beats for moderate and severe concentric LVH compared to mild concentric LVH, can bee found [32]. Schannwell et al [13] also found greater prevalence of supraventricular arrhythmias proportional to the degree of LVH.…”

“…Schannwell et al [13] also found greater prevalence of supraventricular arrhythmias proportional to the degree of LVH. The largest left atrial diameters can bee found in patients with eccentric LVH and the higher prevalence of supraventricular premature beats in the concentric and eccentric type [32]. Some outhors [6,33] found significantly greater prevalence and complexity of supraventricular arrhythmias in patients with asymmetric LVH.…”