Atrial Electrical and Structural Remodeling Associated with Longstanding Pulmonary Hypertension and Right Ventricular Hypertrophy in Humans

Medi, Caroline; Kalman, Jonathan M.; Ling, Liang‐Han; Teh, A.; Lee, Geoffrey; Lee, Geraldine; Spence, S.; Kaye, David M.; Kistler, Peter M.

doi:10.1111/j.1540-8167.2011.02255.x

Cited by 80 publications

(81 citation statements)

References 43 publications

(70 reference statements)

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“…This circuit is dependent on conduction across an isthmus of tissue between the tricuspid valve and inferior vena cava which can be safely and easily ablated with radiofrequecy catheter ablation [29]. This treatment is highly effective in the general population and studies in PAH patients have also shown high rates of success with a 100% acute success rate and approximately 75% long term success rate [7,8,21,30].…”

Section: Reviewmentioning

confidence: 99%

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Arrhythmias in pulmonary arterial hypertension

Temple¹

2017

J Congenit Heart Dis

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Pulmonary arterial hypertension is a condition associated with raised right heart pressures and subsequent remodelling of the right atrium and ventricle with relative preservation of left heart function. There is a high incidence of arrhythmias including atrial fibrillation, atrial flutter and atrioventricular nodal re-entrant tachycardia. Despite recent advances in medical therapy for pulmonary arterial hypertension arrhythmias continue to have a high morbidity and mortality. Treatment includes medical therapy, cardioversion and catheter ablation.

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Section: Reviewmentioning

confidence: 99%

“…In addition to structural remodelling electrophysiological assessment of a population of patients with PAH but no evidence of arrhythmias has shown slowing of conduction in the right atrium. These changes may provide the substrate necessary for the maintenance of atrial flutter [21].…”

Section: Reviewmentioning

confidence: 99%

Arrhythmias in pulmonary arterial hypertension

Temple¹

2017

J Congenit Heart Dis

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“…Consistent with this concept, SAN dysfunction has been demonstrated in association with conditions leading to RA pressure and volume overload, including dyssynchronous AV pacing, pulmonary hypertension and chronic atrial septal defect. 57- 59 In a canine model of HF, cellular electrical remodeling was seen with downregulation of HCN channels in the SAN, lead- 54 ) However, there is conduction block of atrial tachyarrhythmia into the SAN, which may impart heterogeneity on the degree of remodeling that occurs (F). During atrial pacing at a cycle length of 200 ms (green line), the SAN is activated at 600 ms (blue line; OAPs, optical action potentials).…”

Section: Snd In Endurance Athletesmentioning

confidence: 99%

Fibrosis, Electrics and Genetics

Morris

Kalman

2014

Circ J

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The sinoatrial node (SAN) is the normal pacemaker of the heart. During a human lifetime it must initiate approximately 2 billion heartbeats and coordinate the cardiovascular response to our physiological and emotional demands. Disease of the SAN is common, and one of the leading indications for electronic pacemaker implantation. Advances in understanding the genetics and molecular mechanisms determining normal SAN function, and of the pathways controlling remodeling are revealing SAN disease to be heterogeneous. We review the contemporary concepts of SAN function, heart rate adaptation and SAN disease from the molecular level to clinical application. (Circ J 2014; 78: 1272 -1282

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“…Chronically elevated right atrial pressure causes its remodeling and promotes supraventricular arrhythmias [1] -a factor of worse prognosis in this group [2].…”

Section: Balloon Atrial Septostomy In Pulmonarymentioning

confidence: 99%