[Systemic thrombolysis: clinical functional assessment of electrical instability of the heart].
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Biomedical subjects
Publications and source records attributed to N V Pozdniakova.
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The prognostic value of ventricular late potentials (VLP) and the character of rhythm disturbance were studied in 64 patients with acute coronary syndrome. 8 hours after system thrombolysis procedure VLP rate increased from 68.6% up to 85.7%. In all cases of reperfusion arrhythmia deterioration of signal-averaged ECG (SAECG) parameters and VLP were observed. Within the hospital treatment period VLP rate in the 1st group (patients receiving thrombolytic therapy) was lower than in the 2nd (no thrombolytic therapy). In the 1st group VLP was observed in 31.4% of the patients on the 10th day and in 11.4% by the end of hospital treatment; in the 2nd group--in 48.3% and 41.4% of the patients, respectively (p < 0.05). Administration of beta-adrenoblockers in both groups allowed improvement of SAECG parameters and cardiac rhythm variability.
Effects of monotherapy with class IC, II and III antiarrhythmic drugs on parameters of signal averaged (SA) ECG and heart rate variability were studied in 88 patients (mean age 45.6+/-7.8 years). Class IC drugs (ethacizine, disopyramide) caused worsening of qualitative parameters of SA ECG and appearance of ventricular late potentials. Therapy with beta-adrenoblockers, amiodarone and sotalol in patients with ventricular arrhythmias was associated with improvement of parameters of SA ECG, lowering of sympathetic and augmentation of parasympathetic activity without sings of arrhrythmogenic and negative inotropic effects. Combination of noninvasive diagnostic methods including SA ECG, temporal and spectral analysis of heart rate variability, Holter ECG monitoring can facilitate selection of appropriate antiarrhythmic therapy and control of its efficacy.
The study of peculiarities of late ventricular potentials (LVPs) registration in patients with painless myocardial ischemia (PIMI) and painful myocardial ischemia (PMI) in unstable or stable running of ischemic heart disease (IHD) enrolled 113 patients (88 males and 25 females, mean age 52.3 +/- 6.8 years). Follow-up covered 20 +/- 3.2 months. Higher risk was associated with abnormal ECG readings, PlMI, duration of ischemic periods > 70 min for 24 hours, ST depression > 3 mm in heart rate < 100 b/m at the start of the ischemic episodes. Patients with LVPs had PlMI episodes significantly more often. 24-h duration of ischemic episodes and maximal ST depression occurred more frequently in patients with slow fragmental activity. Assessment of Holter ECG monitoring and LVPs allows to ascertain functional status of IHD patients, promotes identification of prognostically unfavourable group of patients at risk of life-threatening arrhythmia and sudden cardiac death.
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