Pulmonary vascular disease & thromboembolismCohort study
Invasive and non-invasive mapping of the cardiac electromechanical substrate in pulmonary arterial hypertension
- Prospective mapping study
- non-invasive electrocardiographic imaging
- invasive right atrial (RA) electroanatomical mapping during ablation
- matched controls
Authors' conclusion
RA dilatation in PAH and CTEPH is associated with slowed conduction, prolonged repolarization, and increased AV nodal refractoriness, providing a mechanistic substrate for atrial arrhythmias and conduction disease. These findings highlight structural-electrophysiological correlations that may guide arrhythmia risk assessment and targeted interventions in PH.
Study context
- Population
- Adult patients with pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (PH) (chronic thromboembolic PH (CTEPH))non-invasive electrocardiographic imaging 30 · invasive RA electroanatomical mapping during ablation 10
- Exposure
- PAH patients vs matched controls
Main finding
As reported in the abstract
PAH patients
72 ± 17
ms
matched controls
46 ± 12
ms
P = 0.001
Observational data: associations, not effects.
Further findings
| Outcome | PAH patients | matched controls | P value |
|---|---|---|---|
| Ventricular activation time (non-invasive mapping) · prolonged in PAH patients | 41 ± 13 ms | 31 ± 6 ms | P = 0.009 |
| Ventricular repolarization time (non-invasive mapping) · prolonged in PAH patients | 127 ± 51 ms | 87 ± 25 ms | P = 0.007 |
| Ventricular activation-recovery interval (non-invasive mapping) · prolonged in PAH patients | 292 ± 30 ms | 246 ± 25 ms | P = 0.001 |
RA dilatation vs atrial conduction and repolarization (non-invasive mapping)
- slower atrial conduction R
- R = 0.51, P = .01
- prolonged repolarization R
- R = 0.40, P = .02
RA volume vs atrial conduction velocity and atrioventricular (AV) nodal effective refractory period (invasive mapping)
- atrial conduction velocity R
- R = −0.64, P = .05
- atrioventricular (AV) nodal effective refractory period R
- R = 0.82, P = .03
Original publication
Summarised from the published abstract; every number is checked against it