T. N. Novikova, V.A. Basova, L. S. Evdokimova, Natalia A. Gnevasheva, I. E. Itskovich, V. Novikov, Sergey A. Saiganov, Vladislava A. Shcherbakova
The article presents a clinical case of a combination of mitral valve prolapse (MVP), mitral annular disjunction (MAD), and ventricular arrhythmia. The presence of MAD worsens the prognosis in MVP and predisposes to life-threatening ventricular arrhythmias. In a 42-year-old patient, MAD was detected during echocardiography to determine the indications for surgical correction of mitral insufficiency in MVP. Severe myxomatous degeneration of the mitral valve leaflets, polysegmental prolapse, and typical auscultatory pattern (systolic click followed by systolic murmur in the second half of systole) were the indications for the targeted search for MAD. Multi-day (ECG) monitoring recorded nonsustained ventricular tachycardias and premature ventricular complexes (PVCs). Cardiac magnetic resonance imaging was performed for confirmation the diagnosis and searched for left ventricular myocardial fibrosis accompanying MAD. Finally, MAD was confirmed, but myocardial fibrotic changes were not detected. Owing to the absence of myocardial fibrosis, the patient was treated conservatively with a beta-adrenoblocker (25 mg/day slow-release metoprolol succinate) in combination with 25 mg/day allaforte. Repeated 24-h ECG monitoring did not detect ventricular tachycardias and nonsustained registered a significant decrease of number of PVCs. The patient is followed up prospectively due to high risk factors for fibrosis and worsening prognosis, which may require surgical correction of the existing disturbances and/or implantation of a cardioverter-defibrillator.
{"title":"A Case of Mitral Annular Disjunction Combined with Ventricular Arrhythmias","authors":"T. N. Novikova, V.A. Basova, L. S. Evdokimova, Natalia A. Gnevasheva, I. E. Itskovich, V. Novikov, Sergey A. Saiganov, Vladislava A. Shcherbakova","doi":"10.17816/cardar109160","DOIUrl":"https://doi.org/10.17816/cardar109160","url":null,"abstract":"The article presents a clinical case of a combination of mitral valve prolapse (MVP), mitral annular disjunction (MAD), and ventricular arrhythmia. The presence of MAD worsens the prognosis in MVP and predisposes to life-threatening ventricular arrhythmias. In a 42-year-old patient, MAD was detected during echocardiography to determine the indications for surgical correction of mitral insufficiency in MVP. Severe myxomatous degeneration of the mitral valve leaflets, polysegmental prolapse, and typical auscultatory pattern (systolic click followed by systolic murmur in the second half of systole) were the indications for the targeted search for MAD. Multi-day (ECG) monitoring recorded nonsustained ventricular tachycardias and premature ventricular complexes (PVCs). Cardiac magnetic resonance imaging was performed for confirmation the diagnosis and searched for left ventricular myocardial fibrosis accompanying MAD. Finally, MAD was confirmed, but myocardial fibrotic changes were not detected. Owing to the absence of myocardial fibrosis, the patient was treated conservatively with a beta-adrenoblocker (25 mg/day slow-release metoprolol succinate) in combination with 25 mg/day allaforte. Repeated 24-h ECG monitoring did not detect ventricular tachycardias and nonsustained registered a significant decrease of number of PVCs. The patient is followed up prospectively due to high risk factors for fibrosis and worsening prognosis, which may require surgical correction of the existing disturbances and/or implantation of a cardioverter-defibrillator.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":"128 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88733228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We present a clinical case of cardiac resynchronization device implantation in a patient with a zone of late left ventricular activation in the area of the anterior coronary sinus vein, which, however, was unsuitable for endovascular implantation and stable electrode placement in it. This anatomical feature was diagnosed at the outpatient stage using a noninvasive mapping technique. Using this approach, we were able to understand that an epicardial electrode implantation, instead of traditional endovascular implantation of the left ventricular electrode through the coronary sinus vein, is indicated for the patient. Targeted implantation of an epicardial electrode in the area of interest on the epicardial surface of the left ventricle in the basal part of the anterolateral wall allowed achieving a complete clinical response to resynchronization therapy.
{"title":"Preoperative Prediction of Optimal Method and Site of Left Ventricular Electrode Implantation","authors":"Vera Stepanova, V. Marinin, S. Zubarev","doi":"10.17816/cardar108644","DOIUrl":"https://doi.org/10.17816/cardar108644","url":null,"abstract":"We present a clinical case of cardiac resynchronization device implantation in a patient with a zone of late left ventricular activation in the area of the anterior coronary sinus vein, which, however, was unsuitable for endovascular implantation and stable electrode placement in it. This anatomical feature was diagnosed at the outpatient stage using a noninvasive mapping technique. Using this approach, we were able to understand that an epicardial electrode implantation, instead of traditional endovascular implantation of the left ventricular electrode through the coronary sinus vein, is indicated for the patient. Targeted implantation of an epicardial electrode in the area of interest on the epicardial surface of the left ventricle in the basal part of the anterolateral wall allowed achieving a complete clinical response to resynchronization therapy.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85323930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Obesity is associated with an increased risk of atrial and ventricular arrhythmias, including life-threatening ones. Epicardial adipose tissue (EAT) is located deep under the visceral pericardium (epicardium) and is therefore in direct contact with the underlying myocardium. In pathological conditions, EAT undergoes a phenotypic transition from a neighbor with protective properties to a substrate that secretes many substances that change the electrophysiology of cardiomyocytes by modulating ion currents that disrupt intercellular electrical connections and stimulate fibrosis. An excess of EAT can cause atrial and ventricular conduction disturbances, which are already evident with standard electrocardiography, predispose to the occurrence of the re-entry phenomenon and cardiac arrhythmias. Among the mechanisms of arrhythmogenesis under the influence of EAT, modulation of ion channels and gap junctions, fibrous remodeling and fatty infiltration are more often considered. However, most of these mechanisms have been studied in experimental studies and cannot easily be extrapolated to humans. There is convincing evidence of a direct relationship between EAT volume and the severity of atrial fibrillation, as well as the clinical benefit obtained from weight loss in patients with this arrhythmia. It is likely that the benefits of weight loss may extend to ventricular arrhythmias.
{"title":"Epicardial Adipose Tissue and Cardiac Arrhythmias","authors":"S. Kanorskii","doi":"10.17816/cardar107112","DOIUrl":"https://doi.org/10.17816/cardar107112","url":null,"abstract":"Obesity is associated with an increased risk of atrial and ventricular arrhythmias, including life-threatening ones. Epicardial adipose tissue (EAT) is located deep under the visceral pericardium (epicardium) and is therefore in direct contact with the underlying myocardium. In pathological conditions, EAT undergoes a phenotypic transition from a neighbor with protective properties to a substrate that secretes many substances that change the electrophysiology of cardiomyocytes by modulating ion currents that disrupt intercellular electrical connections and stimulate fibrosis. An excess of EAT can cause atrial and ventricular conduction disturbances, which are already evident with standard electrocardiography, predispose to the occurrence of the re-entry phenomenon and cardiac arrhythmias. Among the mechanisms of arrhythmogenesis under the influence of EAT, modulation of ion channels and gap junctions, fibrous remodeling and fatty infiltration are more often considered. However, most of these mechanisms have been studied in experimental studies and cannot easily be extrapolated to humans. There is convincing evidence of a direct relationship between EAT volume and the severity of atrial fibrillation, as well as the clinical benefit obtained from weight loss in patients with this arrhythmia. It is likely that the benefits of weight loss may extend to ventricular arrhythmias.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90961657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aleksandr I. Olesin, Irina V. Konstantinova, V. Ivanov
AIM: The study aimed to evaluate the influence of the correction of potentially modifiable risk factors for the development of atrial fibrillation (AF) as primary prevention of AF in patients with metabolic syndrome (MS) and premature atrial complexes (PAC). MATERIALS AND METHODS: We monitored 856 MS patients with PAC, aged 5872 (mean age, 66.4 0.7) years, in the north-western region of the Russian Federation. A 5-year risk of AF was calculated in all patients after the examination by determining the potential prognostic time range for Af development and its index of probable occurrence (RCHARGE-AF) using the CHARGE-AF model. The correction of potentially modifiable MS components and risk factors for AF development (smoking cessation, elimination of physical inactivity, etc.) until their target values were achieved was offered to all patients. The follow-up endpoint was the preservation of sinus rhythm or AF registration. RESULTS: All patients with MS were distributed into three groups. Group I consisted of 557 (65.07%) patients with incomplete correction of risk factors, and group II included 93 (10.86%) who achieved the target values of all potentially modifiable factors for AF development. The control group included the remaining patients without quantitative and qualitative changes in the dynamics AF predictors. No significant differences were found between the groups in terms of sex, age, concomitant diseases, and risk factors for AF. The achievement of the target values of the main MS components, including body mass index and/or waist circumference, correlated with the performance of regular aerobic exercises (odds ratio [OR] = 8.9), adherence to a diet (OR = 7.5), duration of MS diagnosis 20 years before the start of correction (OR = 12.8), and intake of a glucagon-like peptide-1 receptor agonist (Liraglutide) (OR = 5.4). In the control group, group I, and group II, AF development did not differ significantly and was registered in 192 (93.20%), 491 (88.15%), and 79 (84.95%) patients (p 0.05), respectively. CONCLUSIONS: In MS patients with PAC and a high 5-year risk of AF, the correction of potentially modifiable risk factors for AF development, as its primary prevention, is ineffective. The determination of the RCHARGE-AF index in MS patients with PAC in dynamics indicates the efficiency of the correction of potentially modifiable risk factors for AF development, but it does not determine the degree of the risk of its occurrence. The authors declare no conflict of interest.
{"title":"Correction of Potentially Modifiable Components of Metabolic Syndrome for the Primary Prevention of Atrial Fibrillation in Comorbid Patients with Premature Atrial Complexes","authors":"Aleksandr I. Olesin, Irina V. Konstantinova, V. Ivanov","doi":"10.17816/cardar105575","DOIUrl":"https://doi.org/10.17816/cardar105575","url":null,"abstract":"AIM: The study aimed to evaluate the influence of the correction of potentially modifiable risk factors for the development of atrial fibrillation (AF) as primary prevention of AF in patients with metabolic syndrome (MS) and premature atrial complexes (PAC). \u0000MATERIALS AND METHODS: We monitored 856 MS patients with PAC, aged 5872 (mean age, 66.4 0.7) years, in the north-western region of the Russian Federation. A 5-year risk of AF was calculated in all patients after the examination by determining the potential prognostic time range for Af development and its index of probable occurrence (RCHARGE-AF) using the CHARGE-AF model. The correction of potentially modifiable MS components and risk factors for AF development (smoking cessation, elimination of physical inactivity, etc.) until their target values were achieved was offered to all patients. The follow-up endpoint was the preservation of sinus rhythm or AF registration. \u0000RESULTS: All patients with MS were distributed into three groups. Group I consisted of 557 (65.07%) patients with incomplete correction of risk factors, and group II included 93 (10.86%) who achieved the target values of all potentially modifiable factors for AF development. The control group included the remaining patients without quantitative and qualitative changes in the dynamics AF predictors. No significant differences were found between the groups in terms of sex, age, concomitant diseases, and risk factors for AF. The achievement of the target values of the main MS components, including body mass index and/or waist circumference, correlated with the performance of regular aerobic exercises (odds ratio [OR] = 8.9), adherence to a diet (OR = 7.5), duration of MS diagnosis 20 years before the start of correction (OR = 12.8), and intake of a glucagon-like peptide-1 receptor agonist (Liraglutide) (OR = 5.4). \u0000In the control group, group I, and group II, AF development did not differ significantly and was registered in 192 (93.20%), 491 (88.15%), and 79 (84.95%) patients (p 0.05), respectively. \u0000CONCLUSIONS: In MS patients with PAC and a high 5-year risk of AF, the correction of potentially modifiable risk factors for AF development, as its primary prevention, is ineffective. The determination of the RCHARGE-AF index in MS patients with PAC in dynamics indicates the efficiency of the correction of potentially modifiable risk factors for AF development, but it does not determine the degree of the risk of its occurrence. \u0000The authors declare no conflict of interest.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85122163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The article demonstrates modern diagnostic capabilities of endocardial electrophysiological examination in cardiological patients with bradysystole and conduction disturbances that allow adequate assessment of the clinical situation. We made an attempt to systematize current indications for an electrophysiological study in this category of patients based on the analysis of several current recommendations.
{"title":"Endocardial Electrophysiological Study in Clinical Practice in Patients with Bradysystole and Conduction Rhythm Disorders: a review","authors":"E. Zhelyakov, A. Ardashev","doi":"10.17816/cardar108972","DOIUrl":"https://doi.org/10.17816/cardar108972","url":null,"abstract":"The article demonstrates modern diagnostic capabilities of endocardial electrophysiological examination in cardiological patients with bradysystole and conduction disturbances that allow adequate assessment of the clinical situation. We made an attempt to systematize current indications for an electrophysiological study in this category of patients based on the analysis of several current recommendations.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88885737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Carvalho, L. Armaganijan, Eduardo Giovanini, César Henrique Morais Alves, Vinícius Motta Machado de Aguiar, Silvio Zampieri Ribeiro, Luadir Gasparotto Júnior, A. Demarchi, Marcos Vinícius de Oliveira Montesi, Paulo de Tarso Jorge Medeiros
We described a case of a 39-year-old asymptomatic patient presenting a coved type 1 Brugada pattern during the recovery phase of treadmill testing. Electrophysiological study resulted in induced polymorphic ventricular tachycardia and implantable cardioverter defibrillator was indicated.
{"title":"Type 1 Brugada Pattern Unmasked During the Recovery Phase of Treadmill Test","authors":"G. Carvalho, L. Armaganijan, Eduardo Giovanini, César Henrique Morais Alves, Vinícius Motta Machado de Aguiar, Silvio Zampieri Ribeiro, Luadir Gasparotto Júnior, A. Demarchi, Marcos Vinícius de Oliveira Montesi, Paulo de Tarso Jorge Medeiros","doi":"10.24207/jca.v35i1.3468","DOIUrl":"https://doi.org/10.24207/jca.v35i1.3468","url":null,"abstract":"We described a case of a 39-year-old asymptomatic patient presenting a coved type 1 Brugada pattern during the recovery phase of treadmill testing. Electrophysiological study resulted in induced polymorphic ventricular tachycardia and implantable cardioverter defibrillator was indicated.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47943820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Novikova, V. Novikov, F. Bitakova, Sergey A. Saiganov, Vladislava A. Shcherbakova
The article presents a clinical case of the development and progression of chronic heart failure (CHF) in a patient with postinfarction cardiosclerosis after implantation of a permanent pacemaker due to binodal dysfunction. The progression of CHF was exacerbated by the patient's transition to a permanent form of atrial fibrillation. Complex therapy for CHF, including cardiac resynchronization therapy, drug therapy with valsartan + sacubitril, empagliflozin, eplerenone, metoprolol succinate (quadrotherapy) led to a complete recovery of the ejection fraction (EF) of the left ventricle. After the patient stopped taking one of the components of quadrotherapy (valsartan + sacubitril), there was a tendency to decrease in EF. The clinical case emphasizes the importance of the timely transformation of traditional permanent pacing into cardiac resynchronization therapy and the appointment of complex modern drug therapy for CHF. When an improvement or restoration of EF is achieved, it is advisable to continue the therapy against which the improvement was obtained in order to avoid the negative consequences that are possible when the components of the quadrotherapy are cancelled.
{"title":"Disease-Modifying Therapy of Chronic Heart Failure on the Background of Heart Rhythm and Conductivity Disorders (Clinical Case)","authors":"T. Novikova, V. Novikov, F. Bitakova, Sergey A. Saiganov, Vladislava A. Shcherbakova","doi":"10.17816/cardar100504","DOIUrl":"https://doi.org/10.17816/cardar100504","url":null,"abstract":"The article presents a clinical case of the development and progression of chronic heart failure (CHF) in a patient with postinfarction cardiosclerosis after implantation of a permanent pacemaker due to binodal dysfunction. The progression of CHF was exacerbated by the patient's transition to a permanent form of atrial fibrillation. Complex therapy for CHF, including cardiac resynchronization therapy, drug therapy with valsartan + sacubitril, empagliflozin, eplerenone, metoprolol succinate (quadrotherapy) led to a complete recovery of the ejection fraction (EF) of the left ventricle. After the patient stopped taking one of the components of quadrotherapy (valsartan + sacubitril), there was a tendency to decrease in EF. The clinical case emphasizes the importance of the timely transformation of traditional permanent pacing into cardiac resynchronization therapy and the appointment of complex modern drug therapy for CHF. When an improvement or restoration of EF is achieved, it is advisable to continue the therapy against which the improvement was obtained in order to avoid the negative consequences that are possible when the components of the quadrotherapy are cancelled.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80429694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yulia O. Govorova, E. Pershina, Pavel A. Tyukov, Alexander V. Аlekhnovich, A. Lischuk, G. Gromyko
In 2020, our department has performed 739 operations on nonpregnant patients. Additionally, 545 highly successful nonfluoroscopic catheter ablation of cardiac arrhythmias were routinely performed using a three-dimensional navigation system, including 47 patients with idiopathic ventricular tachycardia (VT) from the right ventricular outflow tract (RVOT). A 38-year-old female patient with a structurally normal heart was admitted to our hospital in 1011 weeks of her third pregnancy because she sustained recurrent 166 regular heartbeats per minute, wide QRS-complex tachycardia with left bundle branch morphology, and frequent premature ventricular contractions on Holter monitoring with complaints of presyncope and dyspnea. Standard antiarrhythmic drugs failed to control tachycardia. This case report presents our initial successful experience of the rescue zero-fluoroscopy catheter ablation of sustained poorly tolerated idiopathic RVOT tachycardia in a pregnant patient. Our result suggests that this technique may be considered in the few rare cases in which drug-resistant, sustained frequent VT is accompanied by hemodynamic compromise with fluoroscopy contraindication. AIM: Diagnostic algorithm of idiopathic sustained drug-resistant, poorly tolerated VT and the possibility of radiofrequency catheter ablation in the most vulnerable first trimester of pregnancy without fluoroscopy were presented in our case report.
{"title":"Catheter ablation of sustained idiopathic right ventricular outflow tract tachycardia in a pregnant patient without fluoroscopy","authors":"Yulia O. Govorova, E. Pershina, Pavel A. Tyukov, Alexander V. Аlekhnovich, A. Lischuk, G. Gromyko","doi":"10.17816/cardar101549","DOIUrl":"https://doi.org/10.17816/cardar101549","url":null,"abstract":"In 2020, our department has performed 739 operations on nonpregnant patients. Additionally, 545 highly successful nonfluoroscopic catheter ablation of cardiac arrhythmias were routinely performed using a three-dimensional navigation system, including 47 patients with idiopathic ventricular tachycardia (VT) from the right ventricular outflow tract (RVOT). \u0000A 38-year-old female patient with a structurally normal heart was admitted to our hospital in 1011 weeks of her third pregnancy because she sustained recurrent 166 regular heartbeats per minute, wide QRS-complex tachycardia with left bundle branch morphology, and frequent premature ventricular contractions on Holter monitoring with complaints of presyncope and dyspnea. Standard antiarrhythmic drugs failed to control tachycardia. This case report presents our initial successful experience of the rescue zero-fluoroscopy catheter ablation of sustained poorly tolerated idiopathic RVOT tachycardia in a pregnant patient. Our result suggests that this technique may be considered in the few rare cases in which drug-resistant, sustained frequent VT is accompanied by hemodynamic compromise with fluoroscopy contraindication. \u0000AIM: Diagnostic algorithm of idiopathic sustained drug-resistant, poorly tolerated VT and the possibility of radiofrequency catheter ablation in the most vulnerable first trimester of pregnancy without fluoroscopy were presented in our case report.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85268199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AIM: This study aimed to assess cardiovascular risk factors in drivers and assistant drivers of railway engine crews with ventricular rhythm disorders. MATERIALS AND METHODS: The study included 120 patients aged 39 to 61 years (mean age M SD: 50.4 4 years), who were distributed into two groups with and without ventricular rhythm disorders. All participants underwent 12-lead daily ECG monitoring with assessment of noninvasive markers of myocardial electrical instability (circadian profile, QT interval, late ventricular potentials, T-wave alternation, rhythm variability). Traditional factors of cardiovascular risk, the employment period in the profession, and the level of personal and situational anxiety on Spielbergers state-trait anxiety inventory (STAI) were evaluated. RESULTS: In Group 1, in comparison with Group 2, significant differences were revealed in the duration of the PQ interval (during the day and at night) and the indicators of late ventricular potentials (RMS 40 and TotQRSF). When analyzing risk factors, elevated indices of total blood cholesterol were registered in both groups, and the risk on the SCORE scale was at a moderate level. In the group of workers with ventricular rhythm disorders, higher indicators of total blood cholesterol and the frequency of smoking and alcohol consumption were established. In individuals with ventricular rhythm disorders, a significant relationship was detected between the number of registered single monomorphic ventricular extrasystoles and the age of the employee (r = 0.3, р 0.05), and blood pressure level (r = 0.3, р 0.05), and the relationship between the level of anxiety and the registration of single supraventricular extrasystoles was established (r = 0.3, р 0.05). In the Group 2, a significant correlation was revealed between the number of registered single supraventricular extrasystoles and age (r = 0.2, р 0.05), the employment period in the profession of a driver (r = 0.2, р 0.05), the blood pressure level (r = 0.2, р 0.05), and the level of anxiety on the STAI (r = 0.3, р 0.05). CONCLUSIONS: Drivers of railway engine crews with ventricular rhythm disorders are characterized by a higher level of total blood cholesterol and a higher frequency of smoking and alcohol consumption. They have significant changes in the duration of the PQ interval (during the day and at night) and indicators of late ventricular potentials (RMS 40 and TotQRSF) according to Holter monitoring. The relationship of the number of ventricular rhythm disorders with age and the office values of systolic and diastolic blood pressure is noted in drivers of engine crews of railway transport.
{"title":"Factors of Cardiovascular Risk in Drivers of Locomotive Crews of Railway Transport with Ventricular Arrhythmias","authors":"K. V. Metso, V. Nikiforov","doi":"10.17816/cardar96766","DOIUrl":"https://doi.org/10.17816/cardar96766","url":null,"abstract":"AIM: This study aimed to assess cardiovascular risk factors in drivers and assistant drivers of railway engine crews with ventricular rhythm disorders. \u0000MATERIALS AND METHODS: The study included 120 patients aged 39 to 61 years (mean age M SD: 50.4 4 years), who were distributed into two groups with and without ventricular rhythm disorders. All participants underwent 12-lead daily ECG monitoring with assessment of noninvasive markers of myocardial electrical instability (circadian profile, QT interval, late ventricular potentials, T-wave alternation, rhythm variability). Traditional factors of cardiovascular risk, the employment period in the profession, and the level of personal and situational anxiety on Spielbergers state-trait anxiety inventory (STAI) were evaluated. \u0000RESULTS: In Group 1, in comparison with Group 2, significant differences were revealed in the duration of the PQ interval (during the day and at night) and the indicators of late ventricular potentials (RMS 40 and TotQRSF). When analyzing risk factors, elevated indices of total blood cholesterol were registered in both groups, and the risk on the SCORE scale was at a moderate level. In the group of workers with ventricular rhythm disorders, higher indicators of total blood cholesterol and the frequency of smoking and alcohol consumption were established. In individuals with ventricular rhythm disorders, a significant relationship was detected between the number of registered single monomorphic ventricular extrasystoles and the age of the employee (r = 0.3, р 0.05), and blood pressure level (r = 0.3, р 0.05), and the relationship between the level of anxiety and the registration of single supraventricular extrasystoles was established (r = 0.3, р 0.05). In the Group 2, a significant correlation was revealed between the number of registered single supraventricular extrasystoles and age (r = 0.2, р 0.05), the employment period in the profession of a driver (r = 0.2, р 0.05), the blood pressure level (r = 0.2, р 0.05), and the level of anxiety on the STAI (r = 0.3, р 0.05). \u0000CONCLUSIONS: Drivers of railway engine crews with ventricular rhythm disorders are characterized by a higher level of total blood cholesterol and a higher frequency of smoking and alcohol consumption. They have significant changes in the duration of the PQ interval (during the day and at night) and indicators of late ventricular potentials (RMS 40 and TotQRSF) according to Holter monitoring. The relationship of the number of ventricular rhythm disorders with age and the office values of systolic and diastolic blood pressure is noted in drivers of engine crews of railway transport.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78556885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In recent decades, the number of intracardiac procedures using percutaneous puncture access has increased manifold. Despite the acquisition by operators of expertise and standardization of methods, the problem of complications remains relevant. AIM: to analyze the frequency and nature of complications of percutaneous access in intracardiac interventions. Suggest recommendations to reduce the incidence of complications. MATERIALS AND METHODS: analysis of data published in international peer-reviewed journals on the topic, as well as the experience of the vascular surgery clinic of St. Katarina's Hospital. CONCLUSIONS: the frequency and severity of complications depend on the experience of the operator, the size and frequency of changing the instrument, as well as compliance with the rules of preoperative diagnosis and postoperative management of the patient. RECOMMENDATIONS: standardized preoperative preparation, careful planning of the intervention, analysis of the state of the access vessels, compliance with the rules of vessel puncture and competent performance of postoperative compression in combination with the use of suturing devices according to indications can reduce the frequency and severity of complications.
{"title":"Access Site Complications by Intracardiac Interventions","authors":"A. V. Kimkov","doi":"10.17816/cardar100389","DOIUrl":"https://doi.org/10.17816/cardar100389","url":null,"abstract":"In recent decades, the number of intracardiac procedures using percutaneous puncture access has increased manifold. Despite the acquisition by operators of expertise and standardization of methods, the problem of complications remains relevant. \u0000AIM: to analyze the frequency and nature of complications of percutaneous access in intracardiac interventions. Suggest recommendations to reduce the incidence of complications. \u0000MATERIALS AND METHODS: analysis of data published in international peer-reviewed journals on the topic, as well as the experience of the vascular surgery clinic of St. Katarina's Hospital. \u0000CONCLUSIONS: the frequency and severity of complications depend on the experience of the operator, the size and frequency of changing the instrument, as well as compliance with the rules of preoperative diagnosis and postoperative management of the patient. \u0000RECOMMENDATIONS: standardized preoperative preparation, careful planning of the intervention, analysis of the state of the access vessels, compliance with the rules of vessel puncture and competent performance of postoperative compression in combination with the use of suturing devices according to indications can reduce the frequency and severity of complications.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85521385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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