Rhythm disorders and electrocardiographic abnormalities in adult patients with pulmonary arterial hypertension (RCD code: class II)

Cardiac arrhythmias may occur in the course of pulmonary hypertension as a result of structural changes related to pressure overload, myocardial hypertrophy and chamber dilation. Arrhythmias compromise greatly to clinical course of disease as they are related to clinical decline, worse outcome and prognosis. Common supraventricular arrhythmias (as atrial fibrillation or atrial flutter) are related to clinical deteriorations (in more than 80% of cases) and worse survival. Therefore early recognition and successful treatment is a key to improve outcome. This objective may be achieved by terminating arrhythmias either by (in most of cases) electrical or pharmacological cardioversion. To prevent further recurrence, radiofrequency ablation is a safe and efficient procedure. Data concerning clinical significance of ventricular arrhythmias is not well described. Most common rhythm disorders that occur during cardiorespiratory arrest are as follows: bradycardia, pulseless electrical activity and asystole, while ventricular fibrillation is a rare finding. Chances for successful resuscitation are poor, and prognosis is unfavorable, as 80% of cardiopulmonary resuscitation are unsuccessful and only 6% of patients after cardiac arrest will end up without neurological defects. The article contains also data concerning usefulness of routine electrocardiography in establishing a diagnosis of pulmonary hypertension, assessment of right ventricular hypertrophy and right ventricular overload. JRCD 2013; 1 (5): 4–7