Ventricular Extrasystoly With High Risk of Life-Threatening Arrhythmias Development in Acute Coronary Syndrome Without St Elevation: Evaluation of Revascularization Effectiveness

Олесин, И.; Литвиненко, А. Л.; Аль-Барбари, В.; Tikhonova, L. A.

doi:10.15829/1560-4071-2014-11-38-43

Ross. kardiol. ž.

2015

DOI: 10.15829/1560-4071-2014-11-38-43

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Ventricular Extrasystoly With High Risk of Life-Threatening Arrhythmias Development in Acute Coronary Syndrome Without St Elevation: Evaluation of Revascularization Effectiveness

И. Олесин¹,

А. Л. Литвиненко²,

В. Аль-Барбари³

et al.

Abstract: Цель. Изучение влияния ранней реваскуляризации миокарда на течение острого коронарного синдрома (ОКС) без подъема сегмента ST, осложненного желудочковой экстрасистолией (ЖЭ) с высоким риском развития жизнеугро-жающих желудочковых аритмий (ЖЖА). Материал и методы. Наблюдалось 124 больных ОКС без подъема сегмента ST, осложненным ЖЭ II-V класса по Лауну, с высоким риском развития ЖЖА, который расценивался при наличии патологических значений линейного отклонения предэктопического интервала ЖЭ и индекса риска разви… Show more

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Achievements in Malignant Arrhythmias Prediction Over the Last Decades Cardiology and the Results of Own Research

Denesyuk

2023

Lʹviv. klin. visn.

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Introduction. With severe heart diseases, ventricular arrhythmias and atrial fibrillation can occur. The aim of the study. To analyze the achievements of arrhythmology in the field of predicting malignant arrhythmias over the past decades cardiology and to present the own results. Materials and methods. Literature surway of 34 articles supplemented with own results directed towards prediction of cardiac arrhythmia including the malignant arrhythmias. Results. Conducted investigation identified the following signs predicting the arrhythmias development: left ventricular hypertrophy, blockage of the bundle of His left limb, severe hypertension, diabetes. Left ventricle and left atrial remodeling are predictors of atrial fibrillation development. In patients with coronary arteries disease, predictors of atrial fibrillation development are increased heart volume and size, as well as decreased left ventricle ejection fraction. In 5 monographs on cardiac arrhythmias, predictors of prognosis and algorithms for the development of malignant cardiac arrhythmias are presented in details. Together with professor O. Sychov it was elaborated original classification of supraventricular extrasystoles. Conclusion. Over the past decades, a number of prognostic criteria for malignant cardiac arrhythmias and sudden cardiac death were elaborated. These include: pronounced left ventricle hypertrophy, blockage of the left limb bundle of His, severe form of hypertension, progressive chronic heart failure, the occurrence of T. Killip II and more, ventricular extrasystole 3-5 grades according to B. Laun, ventricular tachycardia of the “pirouette” type, reduction of the left ventricle ejection fraction is less than 40.0 %, thickening of the left ventricle posterior wall and interventricular membrane 14 mm and more, sino-atrial and atrio-ventricular blockage, prolongation of the Q-T interval, use of anti-arrhytmic drugs of IA and IS classes, etc. As a rule, the more of these arrhythmias predictors are exposed, the more often sudden cardiac deaths develops. Hovewer, certain exceptions of this rule sometimes appear. Keywords: coronary heart disease combined with hypertension, diagnostic criteria, predictors of complications progression.

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Achievements in Malignant Arrhythmias Prediction Over the Last Decades Cardiology and the Results of Own Research

Denesyuk

2023

Lʹviv. klin. visn.

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Heart Rhythm and Conductivity Disturbances in Men Under 60 Years Old With Acute Kidney Injury During Myocardial Infarction

V.A.

A.V.

B.B.

et al. 2022

Mediko-farmacevtičeskij žurnal "Pulʹs"

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Relevance. Acute kidney injury (AKI) and arrhythmias negatively affect the prognosis of myocardial infarction (MI). Aim. To evaluate the features of heart rhythm and conduction disturbances and electrocardiographic changes in men under 60 years old (y.o.) with AKI in MI to improve understanding of the mechanisms of development and prevention. Material and methods. The study included men aged 19-60 years old with MI and AKI were studied. The patients were divided into two age comparable groups: I - study group, with AKI - 25 patients; II - control, without it - 486 patients. A comparative analysis of the frequency of observation of arrhythmias and ECG changes in the selected groups, analysis of the influence of various factors (Pearson's Chi-square) on the risk of arrhythmia in the study group were performed. Results. The compared groups did not differ in the frequency and structure of cardiac arrhythmias and conduction disorders. For the development of arrhythmias in the study group, the most important were: diastolic (absolute risk (AR): 100%; relative (RR) - 5.3; p = 0.02) 120 mm Hg. and more and systolic (AR: 83.3%; RR: 5.3; p = 0.02) blood pressure (BP) 180 mm Hg or more, the early and late left ventricular (LV) filling velocity relationship less than 0,7 (AR: 66.7%; p = 0.002), left atrial 38 mm or more (AR: 53.3%; p = 0.007), LV end-systolic volume index (52.4 ml / m2 or more) and LV end-diastolic index (88.0 ml / m2 and more) (AR: 66.7% each; RR: 4.67 each; p = 0.01). For the development of life-threatening arrhythmias (ventricular fibrillation and asystole) in the study group, a body weight of 110.0 kg or more was of additional importance (AR: 50.0%; p = 0.01). New arrhythmias in the subacute MI period were recorded only in the control group of patients. Conclusions. For AKI in MI in men under 60 y.o., there were no specific heart rhythm and conduction disturbances. For the arrhythmias development in MI with AKI, signs of pronounced hypertension, dilatation of the left heart and LV systolic and diastolic dysfunction are primary importance. Obesity is an additional importance for the life-threatening arrhythmias development in MI with AKI.

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Ventricular Extrasystoly With High Risk of Life-Threatening Arrhythmias Development in Acute Coronary Syndrome Without St Elevation: Evaluation of Revascularization Effectiveness

Cited by 2 publications

References 1 publication

Achievements in Malignant Arrhythmias Prediction Over the Last Decades Cardiology and the Results of Own Research

Achievements in Malignant Arrhythmias Prediction Over the Last Decades Cardiology and the Results of Own Research

Heart Rhythm and Conductivity Disturbances in Men Under 60 Years Old With Acute Kidney Injury During Myocardial Infarction

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