CHARACTERISTICS OF HEART RATE IN LATE PREMATURE NEWBORNS WITH PERINATAL AFFECTION OF CENTRAL NERVOUS SYSTEM

Abstract

The adaptation of late premature babies to the new life conditions is difficult and requires careful monitoring of all vital parameters in the postnatal period. The general immaturity of the newborns in combination with the metabolic and hypoxic disorders "leaves only a narrow corridor" to develop babies their compensatory possibilities. There is an urgent need to investigate posthypoxic myocardial ischemia in newborns due to the fact that in the neonatal period, early diagnosis and correct treatment can prevent long-term adverse consequences of existing disorders. The aim of this study was to develop an approach for early detection of cardiac rhythm disturbances and conduction disorders in late premature infants, who underwent perinatal hypoxia. A single-center study included 93 late premature babies who were born at the Perinatal Center, Poltava, in 2019 – 2020. Group I consisted of newborns (n ​​= 47) with hypoxic-ischemic damage of the central nervous system; group II included premature babies (n = 46) with hypoxic-hemorrhagic damage of the central nervous system. Long-term monitoring of the electrocardiogram was performed with further conversion of the altered QRST-QRST complexes into 2D format with a multi-coloured representation of all components of the ventricular electrical systole. Among heterotopic cardiac arrhythmias, supraventricular extrasystoles were most often recorded in 89.4 ± 4.8% of the children of group I and in 67.4 ± 6.1% of newborns in group II with daytime distribution in both groups. Ventricular extrasystoles were found as significantly more frequent in newborns of group I (21.3 ± 6.3%) compared with children in group II (10.9 ± 6.1%), with a significant increase in the area of ​​ectopic ventricular complexes (1492.2) that indicates a prolonged depolarization process. The study of the bioelectrical activity of the heart based on the findings obtained by monitoring the electrocardiogram with the qualitative and quantitative analysis of the convertible QRST-QRST complexes increases the efficiency of visual diagnosis of electrical instability of the myocardium in late premature infants with perinatal damage of the central nervous system.