Poruchy srdečního rytmu u plicní hypertenze

Dusík, Milan

Pulmonary hypertension (PH) is defined by the elevation of the mean pulmonary artery pressure above 20 mmHg. PH affects about 1% of population. Based on the similar pathophysiological mechanisms, clinical and hemodynamic characteristics, and therapeutic possibilities, PH is classified into 5 groups. Right heart catheterization is a crucial assessment to establish the diagnosis. Supraventricular tachycardias (SVTs), including atrial fibrillation (AF) and other atrial tachycardias (AT), are frequently found in patients with PH with a reported cumulative incidence of 10-36 %. The presence of an SVT in a PH patient leads to further deterioration and worsens the prognosis. This thesis is based on four distinct analyses focused on the SVTs in PH. The first analysis described the arrhythmias in patients with chronic thromboembolic pulmonary hypertension. The prevalence of AF/AT reached 29% and their presence was associated with reduced functional capacity. Despite the improved hemodynamics, the incidence of arrhythmias rose significantly after the pulmonary endarterectomy. The second analysis retrospectively studied the SVT prevalence and its association with PAWP values in patients with pre-capillary PH. Patients with PAWP above 11mmHg had higher arrhythmia prevalence, possibly because of the involvement...

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