Pulmonary Arterial Hypertension Outcomes With Atrial Arrhythmia

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The worst outcomes were seen in patients with systemic sclerosis-related pulmonary arterial hypertension and atrial arrhythmia.
The worst outcomes were seen in patients with systemic sclerosis-related pulmonary arterial hypertension and atrial arrhythmia.

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."

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."

Reference

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

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