Supraventricular Arrhythmias in Patients With Pulmonary Arterial Hypertension

Atrial Arrhythmias in Pulmonary Hypertension: Pathogenesis, Prognosis and Management

“…A similar series of 72 patients from an Italian center reported a 22 % incidence of atrial arrhythmias over 35 months; however, this cohort was also heterogeneous and included patients with WHO group III disease (n=12). 8 More recent prospective studies have confirmed a relatively high incidence of atrial arrhythmias in PH patients and have attempted to characterise the clinical features of those patients at risk of developing such arrhythmias. Olsson et al followed 239 patients with idiopathic PAH (n=157) or CTEPH (n=82) and restricted their analysis to AF and atrial flutter.…”

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

“…[7][8][9]12 Interestingly, in the studies of Wen and Olsson, survival in patients with transient episodes of arrhythmias was not statistically different from patients without arrhythmias. 10,12 Most patients with arrhythmias suffered from symptoms [8][9][10]14 and improved after restoration of SR. 8,12 In Olsson and colleagues' study, restoration of SR was associated with improved 6-MWD and decreased NT-proBNP. 12 Interestingly, in Ruiz-Cano and colleagues' study, 46.4% of the patients needed more specific treatment of PH despite the restoration of SR or control of ventricular rate.…”

“…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.…”

“…Cannillo et al revealed Afib (paroxysmal: n = 1, persistent: n = 8, permament: n = 3), ectopic atrial tachycardia (n = 2), right atrial flutter (n = 2), atrioventricular node reentry tachycardia (AVNRT, n = 1), and paroxysmal supraventricular tachycardia during a follow-up period of 35 months [IQR 21.5 to 53.5] in their patients (mean age = 66.7 years). 9 Detection of arrhythmias occurred during either routine follow up (n = 4) or symptom-related diagnostic treatment (n = 13) in mean 15.1 months [IQR 11.3 to 43.2] after the initial diagnosis of PH. Patients with/ without arrhythmias showed no significant differences.…”

Acute Respiratory Failure in Interstitial Lung Disease Complicated by Pulmonary Hypertension

“…Typically PH has been excluded in clinical trials of atrial fibrillation [95]. Cannillo et al (2015) found that in patients with PAH, including a small representation of Group 3 PH, the presence of a supraventricular (atrial) tachycardia was associated with increased hospitalization and mortality [96]. Generally, rate control agents have negative inotropic effects and are often poorly tolerated in decompensated PH and therefore atrial rhythm control is preferred.…”