Author(s): Elsebaie, Abdelrahman ; Enriquez, Victor Rafael Bucheli ; Baranchuk, Adrian ; Nahin, Marcelo Antonio ; El-Diasty, Mohammad
Date: 2024
Origin: Portuguese Journal of Cardiac Thoracic and Vascular Surgery
Subject(s): Atrial arrhythmias; postoperative atrial fibrillation; chronic thromboembolic pulmonary hypertension; pulmonary thromboendarterectomy; narrative review
Chronic thromboembolic pulmonary hypertension (CTEPH) presents as a progressive vascular condition arising from previous episodes of acute pulmonary embolism, contributing to the development of pulmonary hypertension (PH). Pulmonary thromboendarterectomy (PTE) is the gold-standard surgical treatment for CTEPH; however, it may be associated with postoperative sequelae, including atrial arrhythmias (AAs). This comprehensive literature review explores the potential mechanisms for PTE-induced AAs with emphasis on the role of PH-related atrial remodelling and the predisposing factors. The identified preoperative predictors for AAs include advanced age, male gender, elevated resting heart rate, previous AAs, and baseline elevated right atrial pressure. Furthermore, we explore the available data on the association between post-PTE pericardial effusions and the development of AAs. Lastly, we briefly discuss the emerging role of radiomic analysis of epicardial adipose tissue as an imaging biomarker for predicting AAs.
