Key result
Supraventricular arrhythmias, particularly atrial fibrillation and flutter, are highly prevalent in pulmonary hypertension, where they cause significant clinical deterioration and where rhythm control strategies appear to improve functional outcomes and mortality despite high recurrence rates.
Why the study?
With increased life expectancy and changing demographics in pulmonary hypertension, supraventricular arrhythmias are emerging as important outcomes, motivating a comprehensive review of their mechanistic drivers and clinical implications.
Supraventricular arrhythmias, particularly atrial fibrillation and flutter, cause severe clinical deterioration in pulmonary hypertension by impairing right ventricular filling; consequently, rhythm control strategies (cardioversion and amiodarone) are generally prioritized over rate control to improve hemodynamics and survival.
May support considering rhythm control in pulmonary hypertension with supraventricular arrhythmias; leaves open need for randomized trials to confirm benefit.
Pulmonary Hypertension (PH) is a chronic disease that causes significant structural deterioration in the right atrium and ventricle. In the past 1-2 decades, life expectancy in patients with PH has increased due to improved awareness, diagnosis and advancements in treatment. Increasingly, PH is recognized in older patients with comorbidities. With the changing demographics, supraventricular arrhythmias (SVAs), especially atrial fibrillation and flutter, are emerging as important outcomes in PH. Here, we comprehensively summarize findings from preclinical and clinical studies to define the mechanistic drivers and clinical implications of SVA. In sum, we propose early recognition and targeted management of SVA is important to improve quality of life, morbidity and mortality in patients with PH.
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Kiris et al. (2026) conducted a review in Pulmonary Hypertension with Supraventricular Arrhythmias. Rhythm and rate control strategies was evaluated. Supraventricular arrhythmias, particularly atrial fibrillation and flutter, are highly prevalent in pulmonary hypertension, where they cause significant clinical deterioration and where rhythm control strategies appear to improve functional outcomes and mortality despite high recurrence rates.
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