Allied Professionals (Non-physician submissions only) -> Clinical Research D-PO02 - Poster Session II (ID 47) Poster

D-PO02-037 - Impact Of Atrial Fibrillation And Atrial Tachycardia In Patients With Chronic Thromboembolic Pulmonary Hypertension Treated With Pulmonary Endarterectomy (ID 170)

Disclosure
 Z. Fingrova: Nothing relevant to disclose.

Abstract

Background: Atrial fibrillation (AF) and related atrial tachycardia (AT) have been frequently observed in patients with chronic thrombembolic pulmonary hypertension (CTEPH). Surgical pulmonary endarterectomy (PEA) is an effective treatment for patients with operable CTEPH.
Objective: Clinical impact of AF / AT for patients undergoing PEA is unknown.
Methods: A retrospective study of 197 patients (mean age 60 ± 12 years; 62% males), who were treated for CTEPH with PEA at a single centre between 2003 and 2017, was performed. Median (IQR) follow-up was 4.2 (1.3; 6.4) years. Patients with CTEPH without diagnosis of AT/AF were set as a control group.
Results: In the overall study population (n=197), prevalence of AF / AT was 29% (57 patients). From this group of 57 patients, 17 subjects (30%) had documented AF/AT before PEA. Clinical profile of patients with AF / AT manifestation before and after PEA and control group is shown in Table. Patients with known diagnosis of AF / AT before PEA differed significantly from the patients with diagnosed arrhythmia after PEA in reduced distance during 6MWT (p = 0.04), in decreased number of patients in NYHA I class (p = 0.02) and in mortality rate (p = 0.04). For details see Table.
Conclusion: The occurrence of AF / AT before indication to surgery is associated with lower functional capacity and higher mortality. The profit from PEA is significantly higher in patients without diagnosed AF / AT before the surgical procedure. Arrhythmia evaluation should be part of a PEA procedure indication.
Study population

CTEPH patients without

AF / AT NO

(control)

(n=140)

AF / AT

Before PEA

(n=17)
P1

AF / AT YES

Diagnosed after PEA

(n=40)
P2
NYHA I57 (47%)1 (6%)0.001314 (35%)0.03
6MWT (meters)411 (321; 506)278 (235; 365)0.002364 (298; 473)0.22
Mortality rate27 (23%)8 (47%)0.048 (20%)0.69

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