Rhythm Disorders Research Articles

Trastornos del ritmo cardiaco en pacientes con síndrome de Tako-tsubo

ObjectivesThis study sought to evaluate the incidence, prognosis and treatment of heart rhythm disorders (HRD) in Tako-tsubo syndrome (TTS). BackgroundTTS is associated with HRD. The HRD prognostic value is not well characterized in TTS yet. MethodsThe HRD of patients included in the National Registry of Tako-tsubo syndrome, admitted between 2002 and 2018 and coming from 38 hospitals throughout the country, was analyzed. We analyzed any heart rhythm disorder in patients presented before admission, at admission and in long-term follow-up. ResultsAll types of HRD were described in 259 (23.5%) cases, from a cohort of 1,097 consecutive patients with TTS. HRD was more associated with diabetes mellitus, smoking, hyperuricemia, sleep apnea, anemia with a worse LVEF on admission. The most frequent HRD was a new onset of atrial fibrillation. During hospitalization, patients with HRD showed more complications such as shock on admission, major bleeding, acute renal failure, and combined infections. At follow-up, they presented higher mortality and more major adverse cardiac events, but with a non-significant correlation. ConclusionsThe incidence of HRD in patients with TTS is not infrequent. TTS, when associated with HRD, presents more complications and a worse prognosis both in hospital and in the long term.

International e-Delphi Consensus Recommendations for the Assessment and Diagnosis of Circadian rest-Activity Rhythm Disorders (CARDs) in Patients with Cancer.

Circadian rest-Activity Rhythm Disorders (CARDs) are common in patients with cancer, particularly in advanced disease. CARDs are associated with increased symptom burden, poorer quality of life, and shorter survival. Research and reporting practices lack standardization, and formal diagnostic criteria do not exist. This electronic Delphi (e-Delphi) study aimed to formulate international recommendations for the assessment and diagnosis of CARDs in patients with cancer. An international e-Delphi was performed using an online platform (Welphi). Round 1 developed statements regarding circadian rest-activity rhythms, diagnostic criteria, and assessment techniques. Rounds 2 and 3 involved participants rating their level of agreement with the statements and providing comments until consensus (defined internally as 67%) and stability between rounds were achieved. Recommendations were then created and distributed to participants for comments before being finalized. Sixteen participants from nine different clinical specialties and seven different countries, with 5-35 years of relevant research experience, were recruited, and thirteen participants completed all three rounds. Of the 164 generated statements, 66% achieved consensus, and responses were stable between the final two rounds. The e-Delphi resulted in international recommendations for assessing and diagnosing CARDs in patients with cancer. These recommendations should ensure standardized research and reporting practices in future studies.

P-wave asystole after a tetralogy of Fallot correction surgery.

A rarely seen arrhythmia is the p-wave asystole also mentioned ventricular asystole, ventricular standstill, or third-degree atrioventricular block with no ventricular escape rhythm. It is the result of the lack of impulse formation in ventricles (absence of idioventricular automaticity) or the failure of impulse transmission to ventricles (conduction disturbance)(1). As the name implies, the ventricles stop pumping, resulting in no effective cardiac output during the phenomenon. It is a potentially fatal rhythm disorder and need immediate diagnosis and treatment. We planned to present a case of p-wave asystole, which developed after tetralogy of Fallot total correction surgery.

An in vitro model to study suction events by a ventricular assist device: validation with clinical data.

Introduction: Ventricular assist devices (LVADs) are a valuable therapy for end-stage heart failure patients. However, some adverse events still persist, such as suction that can trigger thrombus formation and cardiac rhythm disorders. The aim of this study is to validate a suction module (SM) as a test bench for LVAD suction detection and speed control algorithms. Methods: The SM consists of a latex tube, mimicking the ventricular apex, connected to a LVAD. The SM was implemented into a hybrid in vitro-in silico cardiovascular simulator. Suction was induced simulating hypovolemia in a profile of a dilated cardiomyopathy and of a restrictive cardiomyopathy for pump speeds ranging between 2,500 and 3,200rpm. Clinical data collected in 38 LVAD patients were used for the validation. Clinical and simulated LVAD flow waveforms were visually compared. For a more quantitative validation, a binary classifier was used to classify simulated suction and non-suction beats. The obtained classification was then compared to that generated by the simulator to evaluate the specificity and sensitivity of the simulator. Finally, a statistical analysis was run on specific suction features (e.g., minimum impeller speed pulsatility, minimum slope of the estimated flow, and timing of the maximum slope of the estimated flow). Results: The simulator could reproduce most of the pump waveforms observed in vivo. The simulator showed a sensitivity and specificity and of 90.0% and 97.5%, respectively. Simulated suction features were in the interquartile range of clinical ones. Conclusions: The SM can be used to investigate suction in different pathophysiological conditions and to support the development of LVAD physiological controllers.

Images: Irregular sleep-wake rhythm disorder in transgender individuals.

Kokash A, Vendrame M. Images: irregular sleep-wake rhythm disorder in transgender individuals. J Clin Sleep Med. 2023;19(11):1981-1984.

Electrophysiological mapping of the epicardium via 3D-printed flexible arrays.

Cardiac electrophysiology mapping and ablation are widely used to treat heart rhythm disorders such as atrial fibrillation (AF) and ventricular tachycardia (VT). Here, we describe an approach for rapid production of three dimensional (3D)-printed mapping devices derived from magnetic resonance imaging. The mapping devices are equipped with flexible electronic arrays that are shaped to match the epicardial contours of the atria and ventricle and allow for epicardial electrical mapping procedures. We validate that these flexible arrays provide high-resolution mapping of epicardial signals in vivo using porcine models of AF and myocardial infarction. Specifically, global coverage of the epicardial surface allows for mapping and ablation of myocardial substrate and the capture of premature ventricular complexes with precise spatial-temporal resolution. We further show, as proof-of-concept, the localization of sites of VT by means of beat-to-beat whole-chamber ventricular mapping of ex vivo Langendorff-perfused human hearts.

Impaired Renal Vein Flow in Atrial Fibrillation: A Potential Risk for Renal Dysfunction.

BACKGROUND Atrial fibrillation (AF) is one of the most common heart rhythm disorders. Identification and early treatment of AF risk factors can improve mortality and morbidity rates. This study aimed to compare the renal venous stasis index (RVSI) and intra-renal venous flow (IRVF) patterns evaluated by intra-renal Doppler ultrasonography in patients with AF and sinus rhythm (SR). MATERIAL AND METHODS A total of 68 patients, 34 with AF (lasting >12 months AF) and 34 with SR (no previous diagnosis of AF and no AF attack in 24-h Holter monitoring) were included in the study. The RVSI was calculated, and the IRVF patterns were determined using intra-renal Doppler ultrasonography. High RVSI was defined as >0.12 RVSI. In addition, echocardiography and a 6-min walk test were performed. A model including diabetes mellitus, hypertension, creatine, Pro-BNP, left ventricular ejection fraction, presence of AF, and systolic pulmonary artery pressure was created to evaluate the effects of variables on high RVSI. RESULTS The RVSI value was significantly higher in patients with AF than in those with SR (P=0.004). The SR group exhibited a higher prevalence of the continuous flow pattern, which is one of the IRVF patterns (P=0.015). In contrast, the biphasic flow pattern was observed more frequently in patients with AF (P=0.003). The presence of AF was found to predict the high RVSI (P=0.002, OR=14.134, 95% CI 2.083-71.277). CONCLUSIONS The presence of AF may affect the IRVF and cause an increase in RVSI.

Bipolar Disorder, Circadian Rhythm and Clock Genes.

Sleep disturbance and abnormal circadian rhythm might be closely related to bipolar disorder. Several studies involving disturbed sleep/wake cycle, changes in rhythms such as melatonin and cortisol, clock genes, and circadian preference have shown the relationship between bipolar disorder and circadian rhythm. The results differed across different studies. In some studies, a delay in the circadian rhythm was observed in the depressive episode and advanced circadian rhythm was observed during the manic episode. In other studies, a delay in circadian rhythm was observed independent of mood episodes. Accordingly, circadian rhythm disorder was proposed as a trait marker for bipolar disorder. The altered circadian rhythm may represent a pathological mechanism that contributes to the mood episodes. However, a prospective cohort study is needed for further clarification.

Cardiovascular system damage in the late-onset Pompe disease

The article presents a clinical case of metabolic hypertrophic cardiomyopathy against the background of a late-onset form of Pompe disease, illustrating the difficulties of differential diagnostic search for the cause of the disease. The clinical, laboratory and genetic aspects of the diagnosis of Pompe disease are highlighted. The features of laboratory diagnostics, the difficult path to the correct diagnosis and the appointment of enzyme replacement therapy are discussed. Much attention is paid to the clinical symptoms of the disease — the most significant damage to the cardiovascular system, there is no damage to the musculoskeletal sphere. Clinical picture of late Pompe disease is presented: cardiac rhythm and conduction disorders (ventricular preexcitation syndrome — multiple additional atrioventricular fenestrations), unstable ventricular tachycardia, supraventricular tachycardia, sinus node weakness syndrome. Considered approaches to the prevention of sudden cardiac death the patient underwent surgical treatment: radiofrequency ablation, endocardial implantation of a cardioverter defibrillator. Pathogenetic therapy for Pompe disease has been started.

The role of individual organization of circadian rhythms in the formation of carbohydrate metabolism disorders

BACKGROUND: In medical literature sources, there are data on the relationship of disorders of circadian rhythms (desynchronosis) with the development of type 2 diabetes mellitus (T2DM). Desynchronosis of circadian rhythms of glycemia can be triggered both by external factors (exposure to excessive artificial lighting in the evening, violation of the diet, «sleep-wake»), and internal — from the individual organization of circadian rhythms (chronotype). In this connection, there is an interest in the most detailed study of the influence of individual characteristics of the organization of circadian rhythms on the risk of developing T2DM. AIM: To characterize the individual organization of circadian rhythms in persons without carbohydrate metabolism disorders, with prediabetes and T2DM with obesity and BMI = 30.0–34.9 kg/m2.MATERIALS AND METHODS: Тhe Horn-Ostberg questionnaires were analyzed retrospectively in individuals with visceral obesity without carbohydrate metabolism disorders (n=40), with prediabetes (n=40) and T2DM (n=40). The results of the Horn-Ostberg test were compared with anamnestic anthropometric, laboratory parameters, nutrition diaries, daily rhythms of integral physiological indicators of carbohydrate and energy metabolism.RESULTS: All study participants (n=120) were identical age 56,7 [52,2; 58,6] years, BMI 31.3 [30.7; 33.9] kg/m2, waist circumference (OW) in women 96.54 ± 1.35 cm in men 98.75 ± 2.61 cm Sex distribution: 73% women and 27% men. Persons with morning chronotype made up 24% (29 people), intermediate 63% (75 people) and evening 13% (16 people) . In the groups, the late time for the first breakfast was noted (without carbohydrate metabolism disorders 9:45h, prediabetes 9:31 and T2DM 10:00h), and 20% of the participants missed it (p<0.05). A larger amount of daily energy value was shifted to the afternoon (p<0.05). Late bedtime was observed in all groups: without carbohydrate metabolism disorders 22.50–00.29h, with prediabetes 22.30–00.29h and T2DM 22.45–00.29h with an increase in sleep duration in the prediabetes group (08.14h, 09.00h and 08.38h, respectively). In all groups, morning and evening chronotypes had correlations with the amplitude of the daily rhythm of glycemia (r=-0.7, p=0.002 and r=-0.6, p=0.035), basal body temperature (r=0.4, p=0.046 and r=-0.5, p<0.0001) and daily energy value (r=-0.6, p= 0.041 and r=-0.6, p=0.05), differing only in the strength of the relationship.CONCLUSION: Thus, people with the morning and intermediate types of the morning chronotype, who organize a daily routine and nutrition that do not correspond to the individual characteristics of this given chronotype, can, along with people of the evening chronotype, become vulnerable in the context of the development of type 2 diabetes.

Features of the course of acute coronary syndrome in medical workers who have undergone a new coronavirus infection

Both in Russia and worldwide, morbidity and mortality from acute coronary syndrome (ACS) remain high. The emergence of a new coronavirus infection, the active participation of medical workers in its elimination, determined a new phenotype of patients, which determines the relevance of the problem and of a more detailed assessment of this cohort of patients. Aim of the study was to identify and determine the clinical and functional features, phenotype and endotype of the course of ACS in medical workers who have had a new coronavirus infection. Material and methods. An open cohort comparative study was conducted. It included 60 healthcare workers with ACS and a previous novel coronavirus infection, who were selected based on the identification of SARS-CoV-2 and/or its antibodies (positive PCR test) in anamnesis. All patients were admitted to the regional vascular center № 7 of the City Clinical Hospital № 2, Novosibirsk. The comparison group consisted of 60 healthcare workers with ACS without positive PCR test in anamnesis. General clinical and instrumental, coronary angiography with possible stenting. Results. Of the 60 medical workers with ACS after a new coronavirus infection, myocardial infarction with ST segment elevation was detected in 21 people, myocardial infarction without ST segment elevation – in 31, unstable angina pectoris – in 8 people. Within 6 months of undergoing COVID-19, they developed complex rhythm disorders, such as paroxysm of fibrillation or atrial flutter, more frequently than in the comparison group, as well as a full AV-blockade (n = 25, 41.6 %, p = 0.020), bradyarrhythmias and conductivity disturbances (n = 8, 13.3 %, p = 0.045), revealed a more than 2-fold increase in the pro-brain natriuretic peptide (proBNP) (n = 21, 35 %, p = 0.033), observed myocardial dysfunction (ejection fraction less than 50 %) (n = 6, 10 %, p = 041). Conclusions. The data obtained indicate the formation of a new ACS phenotype in medical workers who have undergone a new coronavirus infection.

Holiday heart syndrome: frequency and mechanism of development

Holiday heart syndrome is a heart rhythm disorder (usually atrial fibrillation) resulting from alcohol consumption by people who are generally healthy. As a rule, holiday heart syndrome is associated with binge alcohol consumption, while chronic alcoholism is characterized by a slightly different picture of cardiac disorders. The main symptom is palpitations - an irregular heartbeat that feels like skipped or extra heartbeats. Other symptoms are chest pain or pressure, shortness of breath, and fainting. Typically, symptoms resolve spontaneously within 24 hours. An irregular heartbeat can be serious. If the heart palpitations continue for more than a few hours, the patient should seek medical care. Some heart rhythm disorders (arrhythmias) associated with binge holiday heart syndrome can lead to sudden death, which may explain some of the sudden deaths commonly reported in alcoholics. Atrial fibrillation is the most frequent kind of arrhythmia in holiday heart syndrome.

Electrocardiogram Devices for Home Use: Technological and Clinical Scoping Review.

Electrocardiograms (ECGs) are used by physicians to record, monitor, and diagnose the electrical activity of the heart. Recent technological advances have allowed ECG devices to move out of the clinic and into the home environment. There is a great variety of mobile ECG devices with the capabilities to be used in home environments. This scoping review aimed to provide a comprehensive overview of the current landscape of mobile ECG devices, including the technology used, intended clinical use, and available clinical evidence. We conducted a scoping review to identify studies concerning mobile ECG devices in the electronic database PubMed. Secondarily, an internet search was performed to identify other ECG devices available in the market. We summarized the devices' technical information and usability characteristics based on manufacturer data such as datasheets and user manuals. For each device, we searched for clinical evidence on the capabilities to record heart disorders by performing individual searches in PubMed and ClinicalTrials.gov, as well as the Food and Drug Administration (FDA) 510(k) Premarket Notification and De Novo databases. From the PubMed database and internet search, we identified 58 ECG devices with available manufacturer information. Technical characteristics such as shape, number of electrodes, and signal processing influence the capabilities of the devices to record cardiac disorders. Of the 58 devices, only 26 (45%) had clinical evidence available regarding their ability to detect heart disorders such as rhythm disorders, more specifically atrial fibrillation. ECG devices available in the market are mainly intended to be used for the detection of arrhythmias. No devices are intended to be used for the detection of other cardiac disorders. Technical and design characteristics influence the intended use of the devices and use environments. For mobile ECG devices to be intended to detect other cardiac disorders, challenges regarding signal processing and sensor characteristics should be solved to increase their detection capabilities. Devices recently released include the use of other sensors on ECG devices to increase their detection capabilities.

The Role of Circadian Rhythms in Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS), as a most common metabolic disrupted disease, has several main symptoms, including ovarian insufficiency, hyperandrogenism, insulin resistance, etc., which may lead to female infertility. Many studies on the processes of PCOS have been done throughout the years, but unfortunately, the pathophysiology of PCOS is still not fully figured out. The circadian rhythm is the metronomic adjustment of the organisms to the external environment at all levels, from the molecular to the individual. It is revealed in multiple studies that there is a clear association between the progression of PCOS and the disturbance of circadian rhythms. Numerous studies have demonstrated that circadian rhythms can influence the development of PCOS by altering the Wnt/β-catenin, GPCR/cAMP/PKA, PI3K/AKT, and MAPK signaling pathways of the hypothalamic-pituitary-ovarian/hypothalamic-pituitary-adrenal axis, which result in abnormal hormone expression, receptor resistance, and metabolic disorders. The circadian rhythm misalignment may contribute to the formation and development of PCOS through the expression of certain genes that control the canonical signaling pathway. It is foreseeable that more preventive and targeted treatment for PCOS is the hot zone of clinical research in the future. This article aimed to review the state regarding the link between circadian rhythm disorder and PCOS, focus on the pathophysiology of PCOS, explore the pathways of circadian rhythm in the process of PCOS, and seek to offer a clear direction and practical approach for the prevention and treatment of PCOS.

The role of astrocyte in the circadian rhythm

The circadian system can be found in nearly all mammalian organs and cells. The maintenance of circadian rhythms is related to the health of human life. Destroying circadian rhythms has a strong correlation with the emergence of many diseases, such as neurological diseases and cardiovascular diseases. Astrocytes are the most common type of cell in the human central nervous system. In recent years, the autonomous regulatory role of astrocytes in the circadian rhythm of the SCN has received increasing attention. This article aims to briefly introduce the role of SCN astrocytes in maintaining circadian rhythm from three aspects: gene expression of astrocytes, regulation of neurotransmitters by astrocytes, and plasticity of astrocytes. At the same time, this article also reviews the relationship between astrocyte activation and circadian rhythm disorders as a neurological disease, and several drugs targeting astrocytes for the treatment of nervous system diseases related to circadian rhythm disorders were proposed to highlight the potential of targeting SCN astrocytes in the treatment of improving circadian rhythm disorders. Finally, this article summarizes current strategies, future challenges, and therapeutic prospects for astrocyte-targeted therapy to improve circadian rhythm disorders. This review aims to highlight SCN astrocytes’ effect on maintaining the circadian rhythm and their related mechanisms and provide a theoretical basis for the future proposal of targeted treatment strategies with astrocytes.

The Role of Circadian Rhythm in Autism Spectrum Disorder

With the development of technology and gradual enrichment in life, there is a significant increase in attention towards neurodevelopment and child health. Autism Spectrum Disorder (ASD) is defined as a neurological and developmental disorder that affects how people speak, behave, and interact with others. Communication and social interaction issues, sensory abnormalities, repetitive habits, and varying degrees of intellectual disability are some of the symptoms of autism. ASDs influences about 1 in 44 children in the USA, with the number of incidents sharply increasing over the years. Epigenetic neurobiology factors and environment related factors should both be considered when interpreting the pathophysiology that lies behind ASD. The 24-hour physiological cycle that displays an endogenous and entrainable oscillation is known as the circadian rhythm, which is generated by a molecular clock system. Mounting evidence are linking circadian rhythm disorder and autism. This includes sleep chaos as a common epiphenomenon of ASD, melatonin level disorder in ASD and circadian gene dysfunction in ASD. This article revolves around three perspectives: 1) Sleep Disorder in ASD 2) Role of Circadian Biomarkers in ASD 3) Variants and deficiency of circadian genes in ASD. In conclusion, the article reveals the important role circadian rhythm plays in neurodevelopmental processes. Through examining the circadian rhythm not only as an epiphenomenon but also as a possible indicator for ASD, the article anticipates the implication of circadian rhythm in novel treatments of ASD as a conclusion.

Classification of drugs for the treatment of circadian rhythm disorders

Survey studies found that more than 3% of adults have CRSD, and about 16% of teenagers may have CRSD. Although it may be self-limiting, others will cause burden consequences. Many existing papers on drug classification focus on the classification method, or discuss some drug characteristics, but because the target range of drugs is too large, there is no way to expand each drug mentioned, and make their characteristics more detailed and clear. With the development of sleep drug research, there are a lot of reviews on the regulation of circadian rhythm, especially on the circadian rhythm disturbance, but most of them are very detailed studies on a specific drug, such as melatonin or amphetamine. The drugs used to treat circadian disorders can be classed as sedative hypnotics, stimulant stimulants, chronotropic drugs, and gives a cursory mention of other drugs that do not fall into the first three categories. Among the sedatives and hypnotics, barbiturates, benzodiazepines and other drugs include tranquilizers or non-benzodiazepines. Amphetamine, Modafinil and caffeine were mentioned in the stimulant category. The third category of drugs that is mainly described is melatonin. This paper is based on the classification of drugs that regulate circadian rhythm disorders. For each category, at least several representative drugs are proposed and their characteristics are described. It contains basic information about the drug, its properties, mechanism of action, side effects and so on. In the description of drug characteristics, there are also some parts of this article that compare drug effects horizontally. The section on stimulant function discusses how long three different drugs can help to maintain a state of arousal, Differences in side effects were also compared.

The research progress for the treatment of circadian rhythm disorder

With the development of The Times, more and more people need to work at night, which is different from the normal biological clock of life, the body’s internal time and external environmental cues, resulting in the disturbance of circadian rhythm. Circadian rhythm disruptions are common to many people, and people can suffer from problems like chronic sleep deprivation or insomnia. Not only that, but over time it can lead to a variety of diseases that affect their lives and a greatly reduced sense of happiness. Recent research progress has suggested that patients with other medical conditions can also experience symptoms of circadian rhythm disruption. This suggests that the circadian rhythm disorder and the diseases are connected in two ways. Therefore, research that uses circadian rhythms to treat diseases by altering circadian rhythms will bring benefits to patients. In this review, the author first describes the relationship between circadian rhythm and specific diseases, such as hypertension, glucose metabolism, and immune system disorders, thus demonstrating a bidirectional relationship between circadian rhythm disturbance and many diseases. Then, three therapeutic methods of circadian rhythm disorder, namely light therapy, melatonin therapy and lifestyle change, are discussed, also mentions their combined use. The mechanism of action and therapeutic methods are introduced in detail, and the corresponding clinical data are given. Finally, based on the potential of circadian intervention, the future development possibilities are proposed.

Prognosis of Early Outcomes after Isolated Coronary Bypass Surgery: Results of a Single-Center Cohort Study

Background. The importance of predictors of adverse outcomes after coronary bypass surgery needs to be regularly review in view of changing standards of practice. Predicting complications will help reduce current mortality and morbidity among patients who have undergone coronary bypass surgery (CABG). Aims prediction and determination of independent predictors of in-hospital mortality after CABG based on the results of preoperative examination. Methods. In a retrospective cohort single-center study, we analyzed the results of 2239 patients who underwent isolated CABG for the period from September 2018 to August 2021. The primary endpoint of the study was hospital death after CABG. Also, the frequency of: non-fatal myocardial infarction, non-fatal stroke, acute heart failure, postoperative rhythm and conduction disorders, acute renal failure, multiple organ failure, infectious complications was analyzed. Next, we searched for independent predictors and built a prognostic model for assessing the risk of death after CABG. Results. Results. Hospital mortality among patients was 1.34% (n = 30). Independent predictors of death after CABG were: ejection fraction (OR 0.91; 95% CI: 0.880.93; p 0.001), body mass index (OR 0.90; 95% CI: 0.820.99; p = 0.035), glomerular filtration rate (OR 0.97; 95% CI: 0.960.99; p = 0.005), repeated CABG (OR 9.3; 95% CI: 2.7431.24; p 0.001), critical atherosclerotic lesion of the arteries of the lower extremities (OR 4.5; 95% CI: 1.93310.268; p 0.001). The model for predicting the probability of death after CABG had high quality metrics: ROC-AUC 0.838 (95% CI: 0.7470.929; p 0.001), sensitivity 72.4%, specificity 84%. The threshold value of the logistic function P at the cut-off point, which corresponded to the highest value of the Yuden index, was 0.015. The outcome was predicted when the value of the logistic function P was higher than or equal to this value. Conclusion. We have developed a model for predicting in-hospital mortality after CABG based on independent linear predictors: left ventricular ejection fraction, body mass index, glomerular filtration rate, repeated CABG, critical atherosclerotic lesion of the main arteries of the lower extremities.

The effect of the autonomic nervous system on the formation of cardiac arrhythmias in childhood (review)

Heart rhythm disorders (HRDs) are one of the most complex and urgent problems in both adult and pediatric cardiology. One of the important points of research in the field of arrhythmology is the study of the mechanisms of HRD formation. The mechanisms that trigger arrhythmias in children have their own peculiarity associated with the age-related aspects of the formation of both the cardiovascular system and the systems responsible for its regulation, primarily the autonomic nervous system (ANS). The article presents current literature data on the contribution of the ANS to the formation of arrhythmias and the information content of its markers depending on age.