Pulmonary Arterial Hypertension Outcomes With Atrial Arrhythmia

atrial fibrillation
atrial fibrillation
Increased right atrial and pulmonary wedge pressures and increased thyroid disease prevalence were associated with atrial arrhythmia development in idiopathic or systemic sclerosis-related pulmonary arterial hypertension.

Patients with idiopathic or systemic sclerosis-related pulmonary arterial hypertension (PAH) who developed atrial arrhythmias had increased right atrial pressure, pulmonary wedge pressure, and thyroid disease prevalence, according to a recent study published in Pulmonary Circulation.

Baseline measurements were taken of patients with either idiopathic (n=116) or systemic sclerosis-related (n=201) PAH. Health outcomes related to development of atrial arrhythmia were tracked prospectively and compared with those patients who did not develop atrial arrhythmia.

Of the 42 (13.2%) participants who developed atrial arrhythmia, 90.5% of cases resulted in hospitalization. Atrial arrhythmia was also associated with higher right atrial pressure, pulmonary wedge pressure (P <.005), NT-proBNP (P <.05), and thyroid disease prevalence (P <.005). 

Overall, an increase in mortality in participants who developed atrial arrhythmia was not statistically significant, and was similar between patients with idiopathic PAH with atrial arrhythmia and those with systemic sclerosis-related PAH without atrial arrhythmia.

Patients with systemic sclerosis-related PAH who had atrial arrhythmia had the worst outcomes. 

The study authors wrote, “The worst prognosis was observed in patients who developed [atrial arrhythmia] that was not related to the presence of thyroid dysfunction.”

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They added, “These results suggest that [atrial arrhythmia] associated with thyroid dysfunction may be a relatively benign condition, while, on the contrary, [atrial arrhythmia] unrelated to thyroid dysfunction may adversely affect prognosis in PAH patients.”


Mercurio V, Peloquin G, Bourji K, et al. Pulmonary arterial hypertension and atrial arrhythmias: incidence, risk factors and clinical impact [published online March 26, 2018]Pulm Circ. doi:10.1177/2045894018769874

This article originally appeared on Pulmonology Advisor