Journal Article

P.3. Basic Science, Sudden Death Risk Stratification and Ventricular Arrhythmias

E. Berngardt, E. Parmon and A. Tsvetnikova

in EP Europace

Published on behalf of European Heart Rhythm Association of the European Society of Cardiology (ESC)

Volume 7, issue s3, pages S49-S49
Published in print October 2005 | ISSN: 1099-5129
Published online October 2005 | e-ISSN: 1532-2092 | DOI: http://dx.doi.org/10.1016/j.eupc.2005.08.203
P.3. Basic Science, Sudden Death Risk Stratification and Ventricular Arrhythmias

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We report own data of comparative research of HRT parameters (risk predictors for sudden cardiac death (SCD)) in ischemic and nonischemic patients with ventricular arrhythmias (VA) (single and double PVC, accelerated idioventricular rhythm (IR) and ventricular tachycardia (VT)).

The aim of this study was definition of values turbulence onset (TO) and turbulence slope (TS) in patients with VA of various grades of nonischemic and ischemic genesis.

Methods

Holter recordings from 66 patients without IHD (mean age = 55±10,9 years, 55% male; I group) and 49 patients with IHD (mean age = 62±8,8 years, 67% male; II group) with VA of high grades have been analyzed. From two groups 8 patients with subsequent SCD (3- without IHD; 5- with IHD) were analyzed.

TO and TS were determined for each grade of VA with the existing scheme and the formula, followed by calculation average value describing each patient. Results were estimated according to the values accepted for normal (TO<0 % and TS >2.5 ms/beat).

Results

Absolute values TO for patients without IHD and number of pathological values TO for single (in 30,3% - for non IHD group vs 22,4% - for IHD group) and for double PVC (in 44,4% vs 27,6%) were higher than in patients with IHD (p <0,05). For the last group this parameter was more often abnormal (in 35,3 %) and its absolute values (−1,47±5,81%) were lower for episodes of VT/IR. In I group of patients absolute values TS after single (6,35±5,59) and double (4,81±5,32) PVC were lower in comparison with II group of patients (6,88±6,52 and 6,18±6,06), but the frequency of occurrence of pathological values was almost identical. Absolute values TS in ischemic patients after VT/IR were lower (p<0,05) (2,81±3,53 vs 9,30±8,92) and the per cent of abnormal values TS (53,8 %) was higher. In nonischemic patients the answer of sinoatrial node as HRT for single (in 13,6%) and for double (in 28,6%) PVC, and in ischemic - for VT/IR (in 23,1%) was more often abnormal. For half of night VA in nonischemic patients TO was abnormal, combination TO+TS – for 25%; for 46,3% night VA in ischemic patients TS was changed. Pathological HRT for all kinds of VA was revealed approximately in 1/3 patients of I group; in II group the combination TO+TS was found out abnormal in 13% of patients, and TS – in 24% patients. From 8 patients with the subsequent SCD in 2 with IHD - pathological combination TO+TS, in 3 – pathological TS. In 1 patient without IHD HRT parameters were normal, in 1 TS was abnormal for double PVC, in 1 – TO for single PVC.

Conclusions

1. HRT is more often pathological for single and especially for double PVC, and TO - for night VA in patients without IHD.

2. HRT is changed for VT/IR and TS - for night VA in patients with IHD in the greater degree.

3. These findings may point to possible dysbalance between sympathetic and parasympathetic nervous system as decreasing of a sympathetic tone in nonischemic patients and parasympathetic - in ischemic patients.

Journal Article.  0 words. 

Subjects: Cardiovascular Medicine

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