ХОЛТЕРОВСКОЕ МОНИТОРИРОВАНИЕ ЭКГ И РЕСПИРАТОРНОЙ КРИВОЙ У НОВОРОЖДЕННЫХ С ВРОЖДЕННЫМИ ПОРОКАМИ СЕРДЦА: ПИЛОТНОЕ ИССЛЕДОВАНИЕ ТИПА СЛУЧАЙ–КОНТРОЛЬ

Abstract

Objective of the research: analysis of 24-hour ECG indicators with the search for heart rhythm disorders in children with congenital heart defects (CHD) during preparation for surgical correction of heart disease; determination of the number of apnea and periodic breathing (PB) episodes in children with CHD based on the daily pneumogram analysis. Materials and methods: 24-hour ECG monitoring with pneumogram (respiratory curve) recording was performed in 37 newborns in the late neonatal period, on the 13th [10; 16] (Me [95% CI]) day of life. Inclusion criteria: uncorrected congenital heart disease complicated by heart failure (HF) of functional class II – III according to R.D. Ross, and/or arterial hypoxemia. The group included patients whose heart disease hemodynamics did not require urgent or emergency cardiac surgery. The study was performed during the planned preparation for surgical treatment in somatic department. In CHD structure combined heart defects prevailed. Two children with tetralogy of Fallot had only arterial hypoxemia. The comparison group included 73 healthy full-term newborns examined in the early neonatal period – on the 2nd [2; 3] (Me [95% CI]) day of life before discharge. Researchers analyzed the heart rate (HR) during sleep and wakefulness, circadian index, heart rate variability (HRV), the frequency of heart rhythm disorders, the number and duration of apnea and PD episodes. Results and discussion: there was a significantly lower number of PD and sleep apnea episodes in newborns with hemodynamically significant CHD; parameters of HRV and heart rate in children with CHD are characterized by a high level of activity of nervous system sympathetic part due to a severe degree of HF and/or arterial hypoxemia; cardiac arrhythmias in newborns with CHD were represented by a rare single extrasystole.