1-9hypertension and Atrial Voltages at Atrial Appendages

Background: Hypertension has been linked with alterations of atrial electrophysiology, which related to the substrate of atrial fibrillation. However, atrial voltages at atrial appendages and their relationship with hypertension remain undiscovered. The study aimed to investigate atrial voltages at both right and left atrial appendages (RAA and LAA) and their correlations with hypertension in patients with underlying heart disease. Materials & Methods: Subjects with ischemic and/or valvular heart disease undergoing cardiac surgery at Erasmus Medical Center Rotterdam were included. After the heart was exposed during open chest surgery, high-resolution epicardial mapping of the LAA and the RAA during sinus rhythm was performed before starting cardiopulmonary bypass. Custom-made software was used to measure atrial voltages. A history of hypertension was obtained from the electronic medical record before undergoing surgery. Results: Among 133 patients undergoing cardiac surgery, 88 patients (66%) had hypertension. Atrial voltages at the LAA were higher in hypertensive patients compared to non-hypertensive patients (median = 5.36 vs 3.59 p < 0.05), also a correlation between hypertension and atrial voltages at the LAA was identified (r = 0.247, p < 0.05). On the other hand, atrial voltages at the RAA were comparable between hypertensive and non-hypertensive patients (median = 4.30 vs 3.96, p > 0.05), without any correlation was found between hypertension and atrial voltages at the RAA. Conclusions: Atrial voltages at the LAA are higher compared to the RAA within hypertensive patients. Hypertension is also correlated with higher atrial voltages at the LAA. High atrial voltages at the LAA might be associated with structural changes of the LAA impacted by systemic hypertension.