Dosiahnennia arytmolohii u prohnozuvanni zloiakisnykh arytmii pid chas khvorob sertsia za kraini desiatyrichchia (ohliad literatury; rezultaty vlasnykh doslidzhen)

Abstract

Introduction. With severe heart diseases, ventricular arrhythmias and atrial fibrillation can occur. The aim of the study. To analyze the achievements of arrhythmology in the field of predicting malignant arrhythmias over the past decades cardiology and to present the own results. Materials and methods. Literature surway of 34 articles supplemented with own results directed towards prediction of cardiac arrhythmia including the malignant arrhythmias. Results. Conducted investigation identified the following signs predicting the arrhythmias development: left ventricular hypertrophy, blockage of the bundle of His left limb, severe hypertension, diabetes. Left ventricle and left atrial remodeling are predictors of atrial fibrillation development. In patients with coronary arteries disease, predictors of atrial fibrillation development are increased heart volume and size, as well as decreased left ventricle ejection fraction. In 5 monographs on cardiac arrhythmias, predictors of prognosis and algorithms for the development of malignant cardiac arrhythmias are presented in details. Together with professor O. Sychov it was elaborated original classification of supraventricular extrasystoles. Conclusion. Over the past decades, a number of prognostic criteria for malignant cardiac arrhythmias and sudden cardiac death were elaborated. These include: pronounced left ventricle hypertrophy, blockage of the left limb bundle of His, severe form of hypertension, progressive chronic heart failure, the occurrence of T. Killip II and more, ventricular extrasystole 3-5 grades according to B. Laun, ventricular tachycardia of the “pirouette” type, reduction of the left ventricle ejection fraction is less than 40.0 %, thickening of the left ventricle posterior wall and interventricular membrane 14 mm and more, sino-atrial and atrio-ventricular blockage, prolongation of the Q-T interval, use of anti-arrhytmic drugs of IA and IS classes, etc. As a rule, the more of these arrhythmias predictors are exposed, the more often sudden cardiac deaths develops. Hovewer, certain exceptions of this rule sometimes appear. Keywords: coronary heart disease combined with hypertension, diagnostic criteria, predictors of complications progression.