Atrial flutter and fibrillation in patients with pulmonary hypertension

Olsson, Karen M.; Nickel, Nils; Tongers, Jörn; Hoeper, Marius M.

doi:10.1016/j.ijcard.2012.06.024

Cited by 161 publications

(240 citation statements)

References 23 publications

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“…Patients without episodes AF/AFL had statistically significant better survival (5-year survival rate of 68%) as compared to for patients who developed at least 1 incident of AF/AFL (5-year survival rate of 47%). The incidence of AF/AFL during the observation time was associated with increased mortality risk with a hazard ratio of 1.75 [7]. Such observation gives some evidence of safety, feasibility and decent efficacy of ablation for atrial flutter or AVNRT in patients with PH despite structural alterations of the heart.…”

Section: Supraventricular Arrhythmiasmentioning

confidence: 67%

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Rhythm disorders and electrocardiographic abnormalities in adult patients with pulmonary arterial hypertension (RCD code: class II)

Waligóra

Kopeć

Łach

et al. 2013

Journal of Rare Cardiovascular Diseases

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Cardiac arrhythmias may occur in the course of pulmonary hypertension as a result of structural changes related to pressure overload, myocardial hypertrophy and chamber dilation. Arrhythmias compromise greatly to clinical course of disease as they are related to clinical decline, worse outcome and prognosis. Common supraventricular arrhythmias (as atrial fibrillation or atrial flutter) are related to clinical deteriorations (in more than 80% of cases) and worse survival. Therefore early recognition and successful treatment is a key to improve outcome. This objective may be achieved by terminating arrhythmias either by (in most of cases) electrical or pharmacological cardioversion. To prevent further recurrence, radiofrequency ablation is a safe and efficient procedure. Data concerning clinical significance of ventricular arrhythmias is not well described. Most common rhythm disorders that occur during cardiorespiratory arrest are as follows: bradycardia, pulseless electrical activity and asystole, while ventricular fibrillation is a rare finding. Chances for successful resuscitation are poor, and prognosis is unfavorable, as 80% of cardiopulmonary resuscitation are unsuccessful and only 6% of patients after cardiac arrest will end up without neurological defects. The article contains also data concerning usefulness of routine electrocardiography in establishing a diagnosis of pulmonary hypertension, assessment of right ventricular hypertrophy and right ventricular overload. JRCD 2013; 1 (5): 4-7

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Section: Supraventricular Arrhythmiasmentioning

confidence: 67%

“…Olsson et al [7] in their prospective study assessed a risk of a new-onset AFL and AF in patients with PH. They included 239 patients (157 with PAH, 82 with inoperable CTEPH) and observed them from 2005 till 2010.…”

Section: Supraventricular Arrhythmiasmentioning

confidence: 99%

Rhythm disorders and electrocardiographic abnormalities in adult patients with pulmonary arterial hypertension (RCD code: class II)

Waligóra

Kopeć

Łach

et al. 2013

Journal of Rare Cardiovascular Diseases

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“…To match our results with other studies [5,6,9] we investigated survival in patients (n = 100) of PH Groups 1 and 4. Survival data were available for 84 patients and 31 (37%) of them died during follow-up.…”

Section: Mortality and Heart Rhythmmentioning

confidence: 76%

“…Five studies evaluated the incidence of atrial arrhythmias in patients with PH [5][6][7][8][9]. The cumulative incidence varied between 11.7% and 25.1% over periods of 6-13 years.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the prognostic value of electrocardiography parameters and heart rhythm in patients with pulmonary hypertension

et al. 2016

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Background: Several studies have analyzed arrhythmias in patients with pulmonary hypertension (PH) and increased P-wave duration was identified as a risk factor for development of atrial fibrillation (AF 79.4 ± 5.4 months (sinus rhythm), (p = 0.565). Conclusions: Atrial fibrillation predict adverse prognosis in patients with PH and a longer P-wave (> 0.11 s) is associated with shorter survival time. (Cardiol J 2016; 23, 4: 465-472)

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“…One possible explanation is that the older, more morbid and male iPAH participants in the COMPERA study represent a changing demographic admixed with the more stereotypical iPAH patients described in prior studies and the REVEAL registry population (26). There is great potential that this differing demographic has unidentified comorbidities, such as arrhythmias, that could explain the mortality benefit with anticoagulation seen in COMPERA and not REVEAL (27,28). Arguing against this hypothesis, however, is the fact that the REVEAL registry population is actually more similar to the previously published studies that did find survival benefit with anticoagulation (10).…”

Section: Perspectivementioning

confidence: 96%

Where do we go from here? Reappraising the data on anticoagulation in pulmonary arterial hypertension

Cirulis

Ryan

2016

J. Thorac. Dis.

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The use of anticoagulation as part of the treatment regimen in pulmonary arterial hypertension (PAH) remains a topic of debate. A recently published analysis of anticoagulation use in the Registry to Evaluate Early and Long-Term PAH Disease Management (REVEAL) study offers conflicting conclusions regarding the benefit of this therapeutic strategy. There remains no robust randomized trial in PAH weighing the risks versus benefits of including anticoagulation in treatment regimens, leaving clinicians to surmise value in individual patients. Reexamination of available data may help to provide guidance on this controversial topic in the absence of future dedicated investigations.

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Atrial flutter and fibrillation in patients with pulmonary hypertension

Cited by 161 publications

References 23 publications

Rhythm disorders and electrocardiographic abnormalities in adult patients with pulmonary arterial hypertension (RCD code: class II)

Rhythm disorders and electrocardiographic abnormalities in adult patients with pulmonary arterial hypertension (RCD code: class II)

Evaluation of the prognostic value of electrocardiography parameters and heart rhythm in patients with pulmonary hypertension

Where do we go from here? Reappraising the data on anticoagulation in pulmonary arterial hypertension

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