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[Atrial disorders of the heart rhythm in hypertension]
Insights
Hypertensive disease patients often have undiagnosed atrial arrhythmias. Left atrial enlargement greater than 4.0 cm significantly increases arrhythmia risk, detectable with combined Holter monitoring and transesophageal pacing.
Area of Science:
- Cardiology
- Electrophysiology
- Hypertension Research
Context:
- Stage-II hypertensive disease affects cardiac rhythm.
- Latent atrial disturbances are common but often undiagnosed.
- Echocardiography and Holter monitoring are standard diagnostic tools.
Purpose:
- To diagnose latent atrial arrhythmias in hypertensive patients.
- To investigate the correlation between left atrial dimension and arrhythmias.
- To evaluate the efficacy of combined diagnostic methods.
Summary:
- Holter monitoring identified latent atrial arrhythmias in 82.4% of 57 males with stage-II hypertension.
- Left atrial dilatation (>4.0 cm) correlated significantly with increased atrial extrasystoles and tachycardias.
- Transesophageal cardiac pacing readily induced atrial fibrillation in patients with enlarged left atria.
Impact:
- Combined Holter monitoring and transesophageal pacing enhance diagnosis of latent atrial arrhythmias in hypertensive patients.
- Identifies left atrial dimension as a key predisposing factor for arrhythmias.
- Improves outpatient detection and management of cardiac rhythm disturbances in hypertension.
Abstract:
A total of 57 males with stage-II hypertensive disease were studied to diagnose latent atrial disturbances of cardiac rhythm. Holter monitoring showed that latent atrial arrhythmias were diagnosed in 82.4% of patients. There was a significant correlation between the incidence of atrial arrhythmias and the left atrial dimension defined at echocardiography. A dilatation of the left atrium of greater than 4.0 cm serves a factor that predisposes to frequent atrial extrasystoles and atrial tachycardias. The electrical instability of a dilated left atrium was evidenced by diagnostic transesophageal cardiac pacing which readily induced persistent paroxysms of atrial fibrillations in patients with enlarged left atrium. The simultaneous use of Holter monitoring and diagnostic transesophageal cardiac pacing in the outpatient setting enhances their diagnostic value in detecting latent atrial arrhythmias in patients with hypertensive disease.