Analysis of indicators of 24-h holter monitoring ECG in elderly hypertensive patients with atrial fibrillation

Abstract

The prevalence of essential hypertension (EH) defines its significance as the most important population – based risk factor for development of atrial fibrillation (AF). The heart morphological remodelling – the development of left ventricular hypertrophy and its diastolic dysfunc tion, the increase of left atrial sizes is associated with increased risk for the development of atrial and ventricular arrhythmias.The objective: to estimate the rate of arrhythmias in elderly hypertensive patients depending on the form of atrial fibrillation (AF) – persistent or permanent.Patients and methods. Doppler echocardiography and Holter monitoring ECG were investigated in 140 patients aged 60–74 years. The were 20 patients with uncomplicate EH, 60 patients with persistent (PersAF) and 60 – wits permanent (PermAF) AF.Results. It was established that patients EH have high frequency of single ventricular extrasystoles. The presence of AF in hypertensive patients is associated with the increase of myocardial electrical inhomogeneity, with is most expressed in permanent AF: the high gradation ventricular arrhythmias in patients with uncomplicated EH, PersAF and PermAF were 5%, 28% and 62% respectively. In study population the range of corrected QT interval (QTc) of these patients, 10% in EH, 16% – PersAF and 43% – PermAF, had prolonged QTc complexes. There were revealed correlations between dispersion of the QT interval (QTd) and parried ventricular extrasystole (r=0,26; р<0,05), between QTd and grouped ventricular extrasystole (r=0,25; р<0,05). Conclusions. It was found that groups of patients associated with the increase in the frequency and amount of daily, single ventricular extrasystoles and high gradation ventricular arrhythmias a set of structural and functional changes of the heart in elderly patients with arterial hypertension and atrial fibrillation and their relation to electrical heterogeneity of the myocardium.