Arrhythmias in pulmonary arterial hypertension

Prog Cardiovasc Dis. Sep-Oct 2012;55(2):180-6. doi: 10.1016/j.pcad.2012.06.002.


Cardiac arrhythmias are important contributors to morbidity and mortality in patients with pulmonary arterial hypertension (PAH). Such patients manifest a substrate resulting from altered autonomics, repolarization abnormalities, and ischemia. Supraventricular arrhythmias such as atrial fibrillation and flutter are associated with worsened outcomes, and maintenance of sinus rhythm is a goal. Sudden death is a relatively common issue, though the contribution of malignant ventricular arrhythmias versus bradyarrhythmias differs from non-PAH patients. Congenital heart disease patients with PAH benefit from catheter ablation of medically refractory arrhythmias. Clinical studies of defibrillator/pacemaker therapy for primary prevention against sudden death in PAH patients are lacking.

Publication types

  • Review

MeSH terms

  • Arrhythmias, Cardiac / etiology*
  • Arrhythmias, Cardiac / physiopathology
  • Arrhythmias, Cardiac / therapy
  • Cardiac Pacing, Artificial / methods
  • Catheter Ablation
  • Death, Sudden, Cardiac / prevention & control
  • Familial Primary Pulmonary Hypertension
  • Heart Rate
  • Humans
  • Hypertension, Pulmonary / complications*
  • Hypertension, Pulmonary / physiopathology