From the Guidelines
Atrialization of a ventricle is a condition where a portion of the ventricle takes on characteristics of an atrium, most commonly seen in Ebstein's anomaly, where the tricuspid valve is abnormally positioned, causing the upper part of the right ventricle to become "atrialized" and function as part of the right atrium. This condition is characterized by a smaller functioning right ventricle and an enlarged right atrium, leading to inefficient blood pumping and potential complications such as heart failure and arrhythmias 1.
Key Characteristics
- The atrialized portion of the ventricle has thin walls like an atrium and contracts with the atrium rather than with the rest of the ventricle.
- The result is a smaller functioning right ventricle and an enlarged right atrium.
- This abnormality leads to inefficient blood pumping, potential blood backflow, and can cause symptoms like fatigue, shortness of breath, heart rhythm abnormalities, and in severe cases, heart failure.
Clinical Implications
- The severity of symptoms depends on how much of the ventricle has been atrialized and how dysfunctional the tricuspid valve is.
- Surgical repair, including tricuspid valve repair or replacement, selective plication of the atrialized right ventricle, and arrhythmia surgery, may be necessary to improve symptoms and prevent worsening outcomes 1.
- Early surgery is recommended before the development of heart failure or right ventricular systolic dysfunction, as delay is associated with poorer outcomes 1.
From the Research
Definition of Atrialization of a Ventricle
- Atrialization of a ventricle refers to a condition where the ventricular pressure becomes similar to atrial pressure, resulting in abnormal hemodynamic function 2.
- This condition can occur due to severe systolic dysfunction, as seen in cases of acute cardiac rejection, where the ventricle's ability to pump blood is severely impaired 2.
Causes and Associations
- Atrialization of a ventricle can be associated with conditions such as Ebstein's anomaly, where the tricuspid valve is abnormal and the right ventricle is small 3.
- In Ebstein's anomaly, the atrialized chamber can be ventricularized through surgical repair, resulting in improved right atrioventricular valve function and restoration of RV geometry and function 3.
Clinical Significance
- Atrialization of a ventricle can lead to significant clinical consequences, including heart failure and arrhythmias 4.
- The use of angiotensin-converting enzyme inhibitors and other medications may help prevent or manage these conditions, although their effectiveness in preventing atrial and ventricular arrhythmias is still being studied 4, 5, 6.