2015


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2015/№2

Time-related changes in ventricular disorders of heart rhythm during planned radio-endovascular treatment of IHD according to data from 72‑h ECG monitoring in patients with and without a history of myocardial infarction

Gogolashvili N. G.1, Nesterova E. A.1, Protopopov A. V.2, Novgorodtseva N. Ya.1
1 – Federal State Budgetary Scientific Institution, “Research Institute for Medical Problems of the North” at the Siberian Branch of the Russian Academy of Medical Sciences, Partizana Zhukova 3G, Krasnoyarsk 660022, Russia
2 – Regional State Budgetary Institution of Health Care, “Regional Clinical Hospital”, Partizana Zheleznyaka 3A, Krasnoyarsk 66002

Keywords: myocardial infarction, heart rhythm disturbances, prognosis, transcutaneous coronary intervention

DOI: 10.18087/rhj.2015.2.1991

Background. In patients with IHD, transcutaneous coronary interventions (TCI) are associated with a risk of various heart rhythm disorders (HRD), primarily ventricular arrhythmias (VA). Aim. To evaluate time-related changes in ventricular HRD during a planned TCI in IHD patients with and without a history of MI. Materials and methods. 106 patients were examined using the 72‑h Holter ECG monitoring (HM). Group I included 71 patients with a history of MI; group II (control) consisted of 35 IHD patients without a history of MI. The study started one day before the planned onset of the surgery (HM day 1); HM day 2 covered the TCI and subsequent strict bed rest; on day 3, patients returned to their habitual activity regimen. Results. In the group with a history of MI, during the TCI and at 24 hours after the TCI, the proportion of patients with high-grade VA significantly increased to 59.2 % and the proportion of patients with 4B grade ventricular extrasystole (VE) increased to 26.8 %. In patients with a history of MI, at day 3 of HM, the rate of 4B grade VA (25.4 %) remained considerably higher than at baseline (11.3 %) and higher than in the group of patients without a history of MI (8.6 %). Conclusion. The group of patients with a history of MI referred to the planned radio-endovascular treatment for chronic forms of IHD is at higher risk for development of clinically significant ventricular HRD.
  1. Гоголашвили Н. Г., Новгородцева Н. Я., Поликарпов Л. С., Карпов Р. С. Частота нарушений ритма сердца в популяции сельского населения Красноярского края. Терапевтический архив. 2004;76 (1):41–4.
  2. Гоголашвили Н. Г., Литвиненко М. В., Почикаева Т. Н. и др. Возможности препарата Омега-3 полиненасыщенных жирных кислот в лечении больных с желудочковыми нарушениями ритма и инфарктом миокарда в анамнезе. Кардиология. 2011;51 (8):28–31.
  3. Шрейдер Е. В., Бойцов С. А. Проблемы при принятии решения о необходимости эндоваскулярной реваскуляризации у больного с хронической ишемической болезнью сердца. Болезни сердца и сосудов. 2009;3:55–60.
  4. Алекян Б. Г., Стаферов А. В., Закарян Н. В., Фозилов Х. Г. Виды осложнений чрескожных коронарных вмешательств у больных ИБС. Грудная и сердечно-сосудистая хирургия. 2010;6:27–34.
  5. Henriques JP, Gheeraert PJ, Ottervanger JP et al. Ventricular fibrillation in acute myocardial infarction before and during primary PCI. Int J Cardiol. 2005 Dec 7;105 (3):262–6.
  6. Majidi M, Kosinski AS, Al-Khatib SM et al. Reperfusion ventricular arrhythmia «bursts» in TIMI 3 flow restoration with primary angioplasty for anterior ST-elevation myocardial infarction: a more precise definition of reperfusion arrhythmias. Europace. 2008 Aug;10 (8):988–97.
  7. Mehta RH, Harjai KJ, Grines L et al. Sustained ventricular tachycardia or fibrillation in the cardiac catheterization laboratory among patients receiving primary percutaneous coronary intervention: incidence, predictors, and outcomes. J Am Coll Cardiol. 2004 May 19;43 (10):1765–72.
  8. Mehta RH, Starr AZ, Lopes RD et al. Incidence of and outcomes associated with ventricular tachycardia or fibrillation in patients undergoing primary percutaneous coronary intervention. JAMA. 2009 May 6;301 (17):1779–89.
  9. Zhou T, Zhou SH, Liu JN et al. Prevalence and risk factors of peri-procedure electrical storm in acute myocardial infarction patients underwent emergency percutaneous coronary intervention. Zhonghua Xin Xue Guan Bing Za Zhi. 2010 Apr;38 (4):337–41.
  10. Huang JL, Ting CT, Chen YT, Chen SA. Mechanisms of ventricular fibrillation during coronary angioplasty: increased incidence for the small orifice caliber of the right coronary artery. Int J Cardiol. 2002 Mar;82 (3):221–8.
  11. Kearns JB, Murnaghan MF. Ventricular fibrillation during hypothermia. J Physiol. 1969 Jul;203 (1):51–3.
  12. Бобров В. А., Малиновская И. Э. Реперфузионные аритмии: теоретические предпосылки и клинические аспекты. Врачебное дело. 1993;7:23–30.
  13. Gorenek B. Management of Cardiac Arrhythmias in Post-PCI Patients. In: Emerging Pathologies in Cardiology. Ed. Gulizia MM. – Springer Science & Business Media, 2005. – p. 231–9.
  14. Bonnemeier Н, Shcafer U, Ortak J et al. Low doses of intracoronary enalaprilat suppress reperfusion-associated ventricular arrhythmias after primary percutaneous coronary interventions for acute myocardial infarction. Pacing Clin Electrophysiol. 2007 Jan;30 (Suppl1):160–5.
  15. Lown B, Wolf M. Approaches to sudden death from coronary heart disease. Circulation. 1971 Jul;44 (1):130–42.
Gogolashvili N. G., Nesterova E. A., Protopopov A. V. et al. Time‑related changes in ventricular disorders of heart rhythm during planned radio‑endovascular treatment of IHD according to data from 72‑h ECG monitoring in patients with and without a history of myocardial infarction. Russian Heart Journal. 2015;14 (1):59–63

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