Can aortic stenosis lead to arrhythmia?

Question

As I understand, Aortic stenosis restricts the blood flow from the left ventricle to the aorta, this restriction should cause a disruption in the pumping of blood. That would cause the heart to beat at a faster rate. If this happens over a long period of time, can it lead to cardiac arrhythmia?

Answer 1

In the long term, aortic stenosis (AS), especially when untreated, can cause structural changes to the heart that can contribute to arrhythmia.

More specifically, left ventricular (LV) outflow obstruction caused by AS can cause pressure buildup in the LV, which over time can cause LV concentric hypertrophy (I.e., the heart muscle thickens uniformly). Such thickening of the heart can lead to a disruption of normal cardiac electrical activity and can lead to ventricular arrhythmias. An example of a study supporting this in a clinical population is Wolfe et al. 1993 in Circulation (https://www.ncbi.nlm.nih.gov/pubmed/8425327).

In a genetic condition somewhat similar to aortic stenosis, hypertrophic cardiomyopathy, individuals are predisposed to ventricular arrhythmias in a similar fashion, which is a leading cause of sudden cardiac death in these individuals (https://europepmc.org/article/med/1728506).

It is also possible that long-term untreated AS can lead to a backup of pressure into the left atrium, leading to left atrial enlargement, which can cause atrial fibrillation (https://www.sciencedirect.com/science/article/abs/pii/S0002914915018457).

Answer 2

Yes , I feel so . As AS will cause pressure overLoad in LV which will further cause increase pressure for pumping the blood, so chronically which leads to arrhythmic activity