Atrial Arrhythmias in Pulmonary Hypertension: Pathogenesis, Prognosis and Management

Abstract

Atrial arrhythmias, including atrial fibrillation and atrial flutter, are common in patients with pulmonary hypertension and are closely associated with clinical decompensation and poor clinical outcomes. The mechanisms of arrhythmogenesis and subsequent clinical decompensation are reviewed. Practical implications and current evidence for the management of atrial arrhythmias in patients with pulmonary hypertension are summarised.

Keywords: Atrial arrhythmia; antiarrhythmia drug treatment; anticoagulation; cather ablation; prognosis; pulmonary hypertension.

Conflict of interest statement

Disclosure: The authors have no conflicts of interest to declare.

Figures

Figure 1:. Electrocardiogram of a 70-year-old Patient with AF and Severe Pulmonary Hypertension with Right Ventricular Dilatation/Dysfunction

Figure 2:. Mechanistic Pathways for the Pathogenesis of Atrial Arrhythmias in Pulmonary Hypertension and the Associated Pathophysiological Consequences

Figure 3:. Voltage Map of the Right Atrium in a Patient with Pulmonary Hypertension and Multiple Tachycardias of Right Atrial Origin