Journal of Interventional Cardiac Electrophysiology

, Volume 41, Issue 1, pp 9–14

Incidence, predictors, and clinical course of atrial tachyarrhythmias in patients with pulmonary hypertension

Authors

  • Arun Kanmanthareddy
    • Division of Cardiovascular Diseases and Bloch Heart Rhythm Center, Cardiovascular Research InstituteUniversity of Kansas Hospital and Medical Center
  • Yeruva Madhu Reddy
    • Division of Cardiovascular Diseases and Bloch Heart Rhythm Center, Cardiovascular Research InstituteUniversity of Kansas Hospital and Medical Center
  • Hemant Boolani
    • Division of CardiologyHoward University
  • Sowjanya Duthuluru
    • Division of Pulmonary Critical CareUniversity of Kansas Hospital and Medical Center
  • Jayasree Pillarisetti
    • Division of Cardiovascular Diseases and Bloch Heart Rhythm Center, Cardiovascular Research InstituteUniversity of Kansas Hospital and Medical Center
  • Ajay Vallakati
    • Division of Cardiology, Metrohealth Medical CenterCase Western Reserve University
  • Sudharani Bommana
    • Division of Cardiovascular Diseases and Bloch Heart Rhythm Center, Cardiovascular Research InstituteUniversity of Kansas Hospital and Medical Center
  • Donita Atkins
    • Division of Cardiovascular Diseases and Bloch Heart Rhythm Center, Cardiovascular Research InstituteUniversity of Kansas Hospital and Medical Center
  • Timothy Williamson
    • Division of Pulmonary Critical CareUniversity of Kansas Hospital and Medical Center
    • Division of Cardiovascular Diseases and Bloch Heart Rhythm Center, Cardiovascular Research InstituteUniversity of Kansas Hospital and Medical Center
Article

DOI: 10.1007/s10840-014-9928-5

Cite this article as:
Kanmanthareddy, A., Reddy, Y.M., Boolani, H. et al. J Interv Card Electrophysiol (2014) 41: 9. doi:10.1007/s10840-014-9928-5

Abstract

Background

The prevalence and predictors of atrial tachyarrhythmias (ATa) in patients with pulmonary hypertension (PH) is less well understood.

Methods

We performed a retrospective study including 311 patients with PH, confirmed by right heart catheterization in our center between 2007 and 2011. Baseline characteristics, clinical, echocardiographic, and hemodynamic data were collected and compared between patients with and without ATa.

Results

The mean age was 61 ± 13 years with 64 % females. The mean pulmonary artery pressure (mPAP) was 46 ± 20 mmHg, mean left ventricular ejection fraction (LVEF) was 55 ± 13 %, and mean pulmonary capillary wedge pressure (PCWP) was 19 ± 9 mmHg. Of the 311 patients with PH, 121 (39 %) patients had ATa. Patients with ATa were older (p < 0.001) and were more likely to have systemic hypertension (p = 0.03), diabetes (p = 0.015), coronary artery disease (p < 0.001), heart failure (p < 0.001), mitral regurgitation (p = 0.001), impaired LVEF (p = 0.02), and left atrial enlargement (p < 0.001). There was no difference in the prevalence of ATa in mild, moderate, or severe PH. The mean PCWP was higher in patients with ATa (17.9 ± 9 vs 20.3 ± 8; p = 0.022). In multivariate analysis using Cox-proportional hazard model, the independent predictors of mortality were age (HR 1.05; p = 0.003), coronary artery disease (HR 2.34; p = 0.047), LVEF (HR 0.793; p = 0.023), and mPAP (HR 1.023; p = 0.003).

Conclusion

ATa are common in patients with PH. Left heart disease, left atrial enlargement, and elevated PCWP but not right atrial enlargement or mPAP predict the occurrence of ATa in patients with PH.

Keywords

Atrial tachyarrhythmiasPulmonary hypertensionSupraventricular tachycardiaPulmonary arterial hypertension

Abbreviations

PH

Pulmonary hypertension

AF

Atrial fibrillation

SVT

Supraventricular tachycardia

ATa

Atrial tachyarrhythmia

LVEF

Left ventricular ejection fraction

PCWP

Pulmonary capillary wedge pressure

RHC

Right heart catheterization

mPAP

Mean pulmonary artery pressure

Copyright information

© Springer Science+Business Media New York 2014