Optimization of Life-Threatening Ventricular Ectopy and Sudden Cardiac Death Prevention in Patients with Postinfarction Cardiosclerosis

Andrii Vytryhovskiy

Abstract


The objective of the research was to optimize treatment of patients with ischemic heart disease (postinfarction cardiosclerosis) and concomitant phenomenon of heart rate turbulence based on the study of heart rate turbulence and heart rate variability.

Materials and methods. The study included 100 patients with ischemic heart disease and postinfarction cardiosclerosis complicated by cardiac rhythm disorder (ventricular ectopic beats). Patients were divided into 2 groups according to the type of prophylaxis: Group I received bisoprolol; Group II received quercetin in addition to bisoprolol. A daily dose of bisoprolol was 0.07 mg/kg body weight while a daily dose of quercetin was 1g for 7 days. The control of therapy effectiveness was performed using Holter monitoring of heart rate turbulence and heart rate variability.

Results. Bisoprolol intake by patients with ischemic heart disease and concomitant heart rate turbulence led to significant increase in the stress index as well as the decrease in the overall tension of body regulation, either parasympathetic or sympathetic divisions of the autonomic nervous system and the vasomotor center. Drug intake did not lead to the abnormal physiological correlation between the activity of the subcortical and peripheral components of the nervous systems. While analyzing the changes in the indices of heart rate turbulence and heart rate variability, there was found, that during combination treatment of patients with ischemic heart disease using bisoprolol and quercetin, positive changes appeared in the regulatory parts of the body.

Conclusions. Combination treatment of post-myocardial infarction patients with bisoprolol and quercetin allows us: a) to achieve complete reduction in ventricular ectopic activity in more than half of patients; b) to reduce the number of patients with life-threatening ventricular ectopic beats significantly; c) to maintain the physiological value and the activity of the autonomic nervous system as well as the vasomotor center of the body; d) to decrease the level of turbulence onset and maintain the value of turbulence slope.


Keywords


postinfarction cardiosclerosis; ventricular fibrillation; sudden cardiac death; heart rate turbulence; heart rate variability

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References


Barthel P, Schneider R, Bauer A, Ulm K, Schmitt C, Schömig A, et al. Risk stratification after acute myocardial infarction by heart rate turbulence. Circulation. 2003;108(10):1221–1226. DOI: http://doi.org/10.1161/01.CIR.0000088783.34082.89 [PMid: 12939209]

Barthel P, Schneider R, Malik M, Schmidt G. EMIAT substudy: Impact of age on heart rate turbulence indices. Eur Heart J. 2001;22(Suppl 436):2315

Bauer A, Barthel P, Schneider R, Schmidt G. Dynamics of heart rate turbulence. Circulation. 2001;104(Suppl II-339):1622

Bauer A, Schneider R, Barthel P, et al. Heart rate turbulence dynamicity. Eur Heart J. 2001;22:436

Bauer A, Barthel P, Schneider R. Dynamics of heart rate turbulence as independent risk predictor after dynamic myocardial infarction. PACE. 2002;25(Part II):608

Schmidt G, Malik M, Barthel P, et al. Heart rate turbulence in post-MI patients on and off ß-blockers. PACE. 2000;23(Part II):619

Yap YG, Camm AJ, Schmidt G, Malik M. Heart rate turbulence is influenced by sympathovagal balance in patients after myocardial infarction - EMIAT substudy. Eur J Heart Fail. 2000;2:51 DOI: http://doi.org/10.1016/S1388-9842(00)80180-4

Bauer A, Malik M, Schmidt G, Barthel P, Bonnemeier H, Cygankiewicz I, et al. Heart rate turbulence: standards of measurement, physiological interpretation, and clinical use: International Society for Holter and Noninvasive Electrophysiology Consensus. J Am Coll Cardiol. 2008;52(17):1353–1365. DOI: http://doi.org/10.1016/j.jacc.2008.07.041 [PMid: 18940523]

Berkowitsch A, Guettler N, Neumann T. Turbulence jump - a new descriptor of heart-rate turbulence after paced premature ventricular beats. A study in dilated cardiomyopathy patients. Eur Heart J. 2001;22(Suppl 547):2941

Berkowitsch A, Zareba W, Neumann T, Erdogan A, Nitt SM, Moss AJ, et al. Risk stratification using heart rate turbulence and ventricular arrhythmia in MADIT II: usefulness and limitations of a 10-minute holter recording. Ann Noninvasive Electrocardiol. 2004;9(3):270–279. DOI: http://doi.org/10.1111/j.1542-474X.2004.93600.x [PMid: 15245344]

Ghuran A, Reid F, La Rovere MT, Schmidt G, Bigger JT, Camm AJ, et al. Heart rate turbulence-based predictors of fatal and nonfatal cardiac arrest (The autonomic tone and reflexes after myocardial infarction substudy). Am J Cardiol. 2002;89(2):184–190. DOI: http://doi.org/10.1016/S0002-9149(01)02198-1

Schmidt G, Schneider R, Barthel P. Correlation coefficient of the heart rate turbulence slope: New risk stratifier in post-infarction patients. Eur Heart J. 2001;22:72




DOI: http://dx.doi.org/10.21802/acm.2016.2.4

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