Vol 23, No 4 (2016)
Published online: 2016-06-29

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Evaluation of the prognostic value of electrocardiography parameters and heart rhythm in patients with pulmonary hypertension

Dirk Bandorski, Harilaos Bogossian, Anja Ecke, Christoph Wiedenroth, Ekkehard Gruenig, Nicola Benjamin, Matthias Arlt, Werner Seeger, Eckhard Mayer, Ardeschir Ghofrani, Reinhard Hoeltgen, Henning Gall
Pubmed: 27367480
Cardiol J 2016;23(4):465-472.


Background: Several studies have analyzed arrhythmias in patients with pulmonary hypertension (PH) and increased P-wave duration was identified as a risk factor for development of atrial fibrillation (AF).

Methods: We retrospectively analyzed the incidence of arrhythmias in patients with an initial diagnosis of PH during long-term follow-up and assessed the prognostic value of electrocardiography (ECG) data. Data from 167 patients were analyzed (Dana Point Classification: Group 1: 59 patients, Group 2: 28 patients, Group 3: 39 patients, Group 4: 41 patients). Clinical, 6-min­ute walk distance test, echocardiography and right heart catheterization data were collected, and baseline/follow-up ECGs were analyzed.

Results: Baseline ECGs revealed sinus rhythm in 137 patients. Thirteen patients had newly onset AF during follow-up. In 30 patients, baseline ECG showed AF. Patients with baseline AF showed higher atrial diameters and higher right atrial pressure. Patients with P-wave du­ration > 0.11 s had shorter survival. Other ECG parameters (PQ-interval, QRS-width, QT-/ /QTc-interval) were not associated with survival. Mean survival times were 79.4 ± 5.4 months (sinus rhythm), 64.4 ± 12.9 months (baseline AF) and 58.8 ± 8.9 months (newly onset AF during follow-up) (p = 0.565).

Conclusions: Atrial fibrillation predict adverse prognosis in patients with PH and a longer P-wave (> 0.11 s) is associated with shorter survival time.

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