Main Article Content
The social significance of myocardial infarction (MI) is determined not only by the high mortality of patients, but also by the fact that a significant part of them subsequently develop heart failure (HF), heart rhythm disturbances (HRD), which worsen the quality of life and limit the ability of patients to work. Holter ECG monitoring (HMECG) is one of the most promising approaches for identifying a group at increased risk of developing coronary artery disease and AMI, predicting the course of the pathological process, and developing complications.
The purpose of the study was to study the prevalence of cardiac arrhythmias in patients with Q-wave myocardial infarction. The study included 80 male patients with primary Q-wave MI aged 29 to 60 years (mean age 50.8±0.98 years), not more than 10 days old. All patients underwent HMECG. The analyzed HMECG parameters included average hourly and average daily heart rate, circadian index (CI); the location of the S-T segment of the relative isoline and its configuration; structure of cardiac arrhythmias.
Results: In the vast majority of cases (98.6%), cardiac arrhythmias were detected in patients, including PVA were recorded in 38.8% of cases, in this group, the anterior localization of the process prevailed (71% vs. 49%; χ2=2.911, P< 0.01), the presence of signs of aneurysm (42% versus 10.2%; χ2=10.955, P<0.001) and the detection of 2 or more complications in the acute period of MI (35.5% and 10.2%, respectively; χ2=6.086, p=0.014).
Conclusion. According to the results of HMECG, 98.6% of the examined patients had cardiac arrhythmias, including PAD in 38.8% of cases. In the group of patients with potentially dangerous ventricular arrhythmias (PVA), cases of development of 2 or more complications in the acute period of MI prevailed. In the PVA group, the anterior localization of the process prevailed, the presence of aneurysm signs and the detection of 2 or more complications in the most acute period of MI.
Volkova S. Yu. Prognostic value of determining the plasma level of neurohumoral mediators in the subacute period of Q-wave myocardial infarction // Kardiologiya. - 2008. - No. 10. - S. 24-27.
Froelicher E. S. Usefulness of Exercise Testing Shortly after Acute Myocardial infarction for Predicting 10-Year Mortality // Amer. J. Cardiol. - 1994. - Vol. 74, no. 4. - P. 318-323.
Laucevicius G., Petrulioniene Z., Ryliskyte L. et al. Vascular Dysfunction and wall structural changes in the assessment of cardiovascular risk: are we ready for "more soft" arterial damage criteria? // Seminars in Cardiology. - 2004. - Vol. 10, #2 (A). - P. 12-15.
Bulletin of arrhythmology (Appendix A). - 2009. - 129 p.
Heart rate variability. Standards of measurement, physiological interpretation, and clinical use // Euro. Heart J. - 1996. - Vol. 17. - P. 354-481.
Pekmezovic Z., Konjevic M. Holter monitoring in sleep apnea // Bulletin of Arrhythmology (Appendix A). - 2009. - 129 p.
Macfarlane P., Murray G., McGowan J. et al. Analysis of 24 hour ambulatory ECGs from the CHRISTMAS study (abstract no. 3026) // Circulation. - 2002. - Vol. 106, (suppl. 19). – 613 p.