Inter-atrial conduction time shortens after blood pressure control in hypertensive patients with left ventricular hypertrophy

• Published in: International journal of cardiology 2005-07, Vol.102 (3), p.443-446
• Main Authors: Fuenmayor A, Abdel J., Moreno, Geraldine, Landaeta, Agustín, Fuenmayor P, Abdel M.
• Format: Article
• Language: English
• Subjects: Aged; Angiotensin antagonists; Angiotensin-Converting Enzyme Inhibitors; Arterial hypertension. Arterial hypotension; Atrial Fibrillation - etiology; Atrial Fibrillation - prevention & control; Biological and medical sciences; Blood and lymphatic vessels; Blood Pressure; Cardiology. Vascular system; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Echocardiography, Doppler; Electrocardiography; Female; Heart Atria - physiopathology; Heart Conduction System - physiopathology; Humans; Hypertension; Hypertension - physiopathology; Hypertension - prevention & control; Hypertrophy, Left Ventricular - physiopathology; Inter-atrial conduction time; Male; Medical sciences; Middle Aged; Prospective Studies; Time Factors
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2004.05.038

Assuming that blood pressure control could induce a shortening of the inter-atrial conduction time and prevent atrial fibrillation occurrence, we studied the inter-atrial conduction time in hypertensive patients with left ventricular hypertrophy. Sixty-eight (26 male) 58.34±8.08-year-old patient participated in the study. All were in sinus rhythm and had abnormal blood pressure (163±18/95±9 mm Hg). Their cardiac mass index was increased (151±43 g/m 2 SC) and their left atrial dimension was normal (3.67±0.54 cm). The inter-atrial conduction time was measured in the echocardiogram from the beginning of the electrocardiographic P wave to the beginning of the A wave in the mitral Doppler signal and was corrected for heart rate. Heart rhythm disturbances were monitored clinically and by means of a Holter. Most patients were treated with angiotensin antagonists. It was found that arterial blood pressure decreased significantly after treatment and that the P–A interval was significantly reduced (71.4±14.5 vs. 63.9±11.5 ms). During the follow-up, no patient complained of arrhythmia symptoms or exhibited atrial fibrillation in the Holter recording. In this selected group of patients with hypertensive heart disease (left ventricular hypertrophy), an effective blood pressure control was accompanied by a significant decrease in the inter-atrial conduction time. It is possible that these effects prevent atrial fibrillation.