Próba oceny ryzyka nawrotu złośliwej arytmii komorowej na podstawie prostych nieinwazyjnych badań diagnostycznych

Translated title of the contribution: Attempt to assess the risk of recurrence of life-threatening ventricular arrhythmia using simple non-invasive tests

Ludmiła Daniłowicz-Szymanowicz, Grzegorz Raczak, Gian Domenico Pinna, Roberto Maestri, Małgorzata Szwoch, Andrzej Lubiński, Jacek Kubica, Grazyna Świa̧tecka

Research output: Contribution to journalArticle

Abstract

Baroreflex sensitivity (BRS), as assessed using phenylephrine method, and depressed 24- hour heart rate variability (HRV) have been shown to be powerful predictors of life- threatening ventricular arrhythmias. However, before these tests are widely used, their methodology has to be simplified. The aim of this study was to assess the prognostic value of simple non- invasive BRS parameter (Robbe index, BRS-RI) and short- term HRV, together with left ventricular ejection fraction (LVEF) and late potentials (LP) assessment in patients after myocardial infarction (MI) with documented history of ventricular tachycardia (VT) and ventricular fibrillation (VF). Material and methods. The observation was conducted on 53 patients after MI with documented VT or VF. . They were was devided into two group: with or without reccurence arrhythmia. During the follow- up malignant ventricular arrhythmia events occurred in 31 patients VT/VF(+), no VT or VF was recorded in the 22 subjects VT/VF(-). In all patients the following parameters were analyzed: BRS-RI (transfer function, 0.07-0.14 Hz), HRV parameters such as: SDNN, rMSSD, pNN50, LF, LF (NU), LF/HF. Additionally, LVEF and LP were assessed. Results. In the VT/VF(+) and VT/VF(-) groups, values of analyzed parameters were: BRS-RI: 4.4 ± 2.5 and 8.4 ± 6.1 ms/mm Hg (p=0.03); BRS-RI≤3 ms/mm Hg: 8/15 and 2/16 (p=0.02); SDNN: 23.0 ± 18.0 and 20.0 ± 11.6 ms (p=0.99); rMSSD: 70.9 ± 69.8 and 34.1 ± 30.2 ms (p=0.34); pNN50: 10.7 ± 14.6 and 4.4 ± 9.0% (p=0.7); LF: 204.5 ± 509.7 and 160.7 ± 265.8 ms 2 (p=0.95); LF (NU): 0.5+0.4 and 0.5 ± 0.3 (NU) (p=0.77); LF/HF: 1.3 ± 1.2 and 2.1 ± 2.2 (p=0.49); LVEF: 32.5 ± 9.1 and 39.8 ± 13.3% (p= 0.03); LP: 19/24 and 15/19 (p= 0.99). The only indices of prognostic values were Robbe- index and LVEF. Their prognostic value in prediction of arrhythmic event occurrence was independent of each other's and of age, time elapsed from MI and number of MI (p= 0,007). Non- diagnostic values of BRS-RI were found in 22 chorych (42%). Conclusions. Among the evaluated indices, only LVEF and Robbe- index have prognostic value in prediction of life- threatening ventricular arrhythmia reccurrence after myocardial infarction. However, a high percentage of non-diagnostic values obtained in BRS-RI assessment limits the usefulness of this index.

Original languagePolish
Pages (from-to)558-563
Number of pages6
JournalPolski Merkuriusz Lekarski
Volume17
Issue number102
Publication statusPublished - 2004

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Keywords

  • Baroreflex sensitivity
  • Heart rate variability
  • Ventricular fibrillation
  • Ventricular tachycardia

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Daniłowicz-Szymanowicz, L., Raczak, G., Pinna, G. D., Maestri, R., Szwoch, M., Lubiński, A., Kubica, J., & Świa̧tecka, G. (2004). Próba oceny ryzyka nawrotu złośliwej arytmii komorowej na podstawie prostych nieinwazyjnych badań diagnostycznych. Polski Merkuriusz Lekarski, 17(102), 558-563.