[Determinants of paroxysmal atrial fibrillation in patients with arterial hypertension].
BACKGROUND
Atrial fibrillation represents an important arrhythmia, in particular in patients with arterial hypertension. Hitherto, the connection between paroxysmal atrial fibrillation, left atrial size and left ventricular muscle mass has not been investigated sufficiently. In the present study, determinants of paroxysmal atrial fibrillation in patients with arterial hypertension were evaluated.


METHODS
104 consecutive patients were enrolled into this study. All of them suffered from arterial hypertension for more than one year. Persistent or permanent atrial fibrillation was not documented. In all of these patients, clinical, echocardiographic and rhythmologic variables were evaluated.


RESULTS
In 10.3% of the patients, paroxysmal atrial fibrillation was found. These patients showed a significantly larger left atrium (43.3 +/- 6.7 vs 37.5 +/- 4.9 mm, p < 0.001), a significantly higher muscle mass of the left ventricle (152.38 +/- 43.57 vs 134.41 +/- 27.19 g/m2, p < 0.01) and significantly more frequent a mild mitral regurgitation (38.1 vs 28.6%, p < 0.01). The multivariate regression analysis revealed as independent factors for paroxysmal atrial fibrillation the size of the left atrium and the presence of mild mitral regurgitation. Independent factors for an enlarged left atrium were mitral insufficiency and left ventricular muscle mass.


CONCLUSIONS
This study shows that paroxysmal atrial fibrillation in aterial hypertension is based on the left atrial size, and left atrial size on left ventricular muscle mass. Therefore, these results should lead to a causal therapy for treatment of paroxysmal atrial fibrillation in these patients.
Hennersdorf
M G
MG
Medizinische Klinik und Poliklinik B Klinik für Kardiologie, Pneumologie und Angiologie Heinrich-Heine-Universität Moorenstr. 5 40225 Düsseldorf, Germany. hennersdorf@med.uni-duesseldorf.de
Hafke
G J
GJ
Steiner
S
S
Dierkes
S
S
Jansen
A
A
Perings
C
C
Strauer
B E
BE
D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology; D003627:Data Interpretation, Statistical; D004452:Echocardiography; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000150:complications*; D017379:Hypertrophy, Left Ventricular / Q000150:complications; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000150:complications
Determinanten des paroxysmalen Vorhofflimmerns bei Patienten mit arterieller Hypertonie.