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


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Fuenmayor
Abdel J
AJ
Clinical Electrophysiology Section, Cardiovascular Research Institute Dr. Abdel M. Fuenmayor P, University of The Andes, Mérida, Venezuela.
Moreno
Geraldine
G
Landaeta
Agustín
A
Fuenmayor
Abdel M
AM
D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors; D001281:Atrial Fibrillation / Q000209:etiology / Q000517:prevention & control; D001794:Blood Pressure; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria / Q000503:physiopathology*; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000517:prevention & control*; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors
D000806:Angiotensin-Converting Enzyme Inhibitors