Atrial flutter regression in HIV-associated pulmonary arterial hypertension after treatment with bosentan

Mario Francesco Damiani, Cristina Scoditti, Elioda Bega, Silvano Dragonieri, Pierluigi Carratù, Alfredo Scoditti, Onofrio Resta
  • Cristina Scoditti
    San Camillo Clinic, Taranto, Italy
  • Elioda Bega
    San Camillo Clinic, Taranto, Italy
  • Silvano Dragonieri
    University of Bari, Italy
  • Pierluigi Carratù
    University of Bari, Italy
  • Alfredo Scoditti
    San Camillo Clinic, Taranto, Italy
  • Onofrio Resta
    University of Bari, Italy

Abstract

Pulmonary arterial hypertension (PAH) is a rare condition characterized by an increase in pulmonary arterial resistance leading to right heart failure and death. Arrhythmias are a growing problem in PAH; therefore, maintenance of sinus rhythm is considered to be an important treatment aim in these patients. We described the case of a 46-year-old woman with HIV-associated pulmonary arterial hypertension  who developed atrial flutter. After treatment with bosentan, it was observed a significant improvement in clinical and haemodynamic parameters. In addition, the AFL, which had previously persisted to both antiarrhythmic drug therapy and electrical stimulation, and had recurred after transthoracic electrical cardioversion, disappeared  in absence of any antiarrhythmic drug. Though the precise factors responsible for supraventricular arrhythmogenesis are still largely obscure, it is likely that initiation and maintenance of AFL may depend on all the conditions that can lead to increase in right atrial pressure, size, and wall stress, such as PAH. In our case, bosentan reduced both mean pulmonary artery pressure (mPAP) value and right heart chambers pressures. Therefore, it is conceivable that with the anatomical substrate needed for the maintenance of AFL being disappeared, sinus rhythm was restored.

Full Text

PDF
Submitted: 2016-09-27 16:10:58
Published: 2016-11-29 11:41:58
Search for citations in Google Scholar
Related articles: Google Scholar
Abstract views:
272

Views:
PDF
54

Article Metrics

Metrics Loading ...

Metrics powered by PLOS ALM


Copyright (c) 2016 Mario Francesco Damiani, Cristina Scoditti, Elioda Bega, Silvano Dragonieri, Pierluigi Carratù, Alfredo Scoditti, Onofrio Resta

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
 
© PAGEPress 2008-2017     -     PAGEPress is a registered trademark property of PAGEPress srl, Italy.     -     VAT: IT02125780185