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Assessment of cardiac arrhythmias using long-term continuous monitoring in patients with pulmonary hypertension

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BACKGROUND: Cardiac arrhythmias are considered a prominent phenomenon in patients with pulmonary hypertension (PH). Older studies reported that 8% to 35% of patients with PH had supraventricular tachycardia (SVT), associated with adverse outcomes. Still, these arrhythmias have only been investigated via short-term monitoring or limited electrocardiogram recordings.

METHODS: Patients without previous arrhythmias diagnosed with PH at a tertiary facility received an insertable cardiac monitor as part of a prospective cohort study. Baseline assessments included World Health Organization functional class, six-minute walk test, echocardiography, and cardiac magnetic resonance imaging.

RESULTS: Thirty-four patients with PH were included. Twenty-four patients had pulmonary arterial hypertension (PAH) and 10 had chronic thromboembolic PH (CTEPH). During 46 patient-years of continuous monitoring (median: 594 (range: 334-654) days per patient), 70 arrhythmia episodes were recorded in 13 patients (38%), with a median of two (range: 1-3) episodes and an arrhythmic burden median of 1.6 (range: 0.1-228) minutes per patient. SVTs were the most common arrhythmias, with 16% of episodes being atrial fibrillation and 84% being other types of SVTs. Additionally, three patients experienced bradycardias, including one resulting in syncope and subsequent pacemaker implantation. None of the patients had sustained ventricular arrhythmias.

CONCLUSIONS: Arrhythmias were seen in 38% of contemporary patients with PH during long-term continuous monitoring; however, the vast majority of episodes were short and self-limiting. Modern therapy may alleviate the development of arrhythmias in stable patients with PH. This study is the first study to deploy long-term continuous monitoring in patients with PH.

Original languageEnglish
JournalInternational Journal of Cardiology
Volume334
Pages (from-to)110-115
Number of pages6
ISSN0167-5273
DOIs
Publication statusPublished - 1 Jul 2021

Bibliographical note

Copyright © 2021. Published by Elsevier B.V.

    Research areas

  • Atrial Fibrillation, Bradycardia, Humans, Hypertension, Pulmonary/diagnostic imaging, Prospective Studies, Tachycardia, Supraventricular, Survival in PH, Continuous long-term monitoring, Supraventricular tachycardia, Arrhythmias, Pulmonary hypertension

ID: 68412447