The Use of β-blockers in Patients with Ventricular Ectopic Heartbeat in the Early and Distant Postinfarction Period

Aim: to increase the effectiveness of patients after Q-, QS- myocardial infarction rehabilitation, based on the study of clinical, instrumental and biochemical changes in cases of cardiac arrhythmias, and development on this basis of new approaches to treatment. Materials and Methods. The clinica...

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Main Author: N. M. Kulayets
Format: Article
Language:English
Published: Zaporizhzhia State Medical and Pharmaceutical University 2017-10-01
Series:Zaporožskij Medicinskij Žurnal
Subjects:
Online Access:http://zmj.zsmu.edu.ua/article/view/110086/107058
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author N. M. Kulayets
author_facet N. M. Kulayets
author_sort N. M. Kulayets
collection DOAJ
description Aim: to increase the effectiveness of patients after Q-, QS- myocardial infarction rehabilitation, based on the study of clinical, instrumental and biochemical changes in cases of cardiac arrhythmias, and development on this basis of new approaches to treatment. Materials and Methods. The clinical, instrumental and biochemical examinations were carried out for 70 patients who had Q-, QS-myocardial infarction (MI) with a ventricular ectopic heartbeat on the regenerative period since the acute coronary syndrome development in 1, 3, and 6 months. The features of the ventricular ectopic heartbeat course in patients with myocardial infarction against the backdrop of sotalol and carvedilol use and influence of applied treatment on the clinical and pathogenetical features of patients’ functional recovery in early and distant (prolonged) postinfarction period were analyzed. Results. Analyzing the dynamics of coronary artery disease clinical manifestations in patients with ventricular arrhythmia (VA) with myocardial infarction against the backdrop of sotalol and carvedilol treatment it has been noted a marked decrease in anginal chest pain manifestation, feeling of palpitations, disruption of the heart, shortness of breath, feeling of breath shortness, etc. in all groups of patients. The positive effect of therapy had been increasing since the 3 week during the 3-month long treatment. Results of heart rate Holter monitoring have shown a marked antiarrhythmic effect of metoprolol, carvedilol and sotalol. In particular, in all groups of patients the frequency of VA reduced by half, the percentage of high grade VA decreased namely pair and group arrhythmia, ventricular bigeminy. Assessment of hemodynamic parameters in the process of patients with ST treatment has represented the marked trend and a further significant increase in ejection fraction and other contractile dysfunction forms correction. This positive trend was the most relevant in the application of carvedilol, a slightly less in patients treated with metoprolol and sotalol. Conclusions. Sotalol in patients after ACS has an ability to reduce the ventricular ectopic heartbeat episodes number and prevents life-threatening arrhythmias, provides a permanent and controlled decrease of heart rate, corrects left ventricle (LV) contractility and processes of postinfarction remodeling of the heart. When using carvedilol it has been noticed a reduction of LV postinfarction remodeling processes, improvement of contractile function of myocardium, antianginal and antiarrhythmic effects, normalization of heart rate variability, reduction of myocardial ischemia, reduction in sudden cardiac death cases. acute coronary syndrome; ventricular premature complexes; ischemic heart disease; myocardial infarction; sotalol; carvedilol
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spelling doaj-art-0f00306d0cf94136901954b71a01cfeb2025-08-20T03:54:32ZengZaporizhzhia State Medical and Pharmaceutical UniversityZaporožskij Medicinskij Žurnal2306-41452310-12102017-10-01555155610.14739/2310-1210.2017.5.110086The Use of β-blockers in Patients with Ventricular Ectopic Heartbeat in the Early and Distant Postinfarction PeriodN. M. KulayetsAim: to increase the effectiveness of patients after Q-, QS- myocardial infarction rehabilitation, based on the study of clinical, instrumental and biochemical changes in cases of cardiac arrhythmias, and development on this basis of new approaches to treatment. Materials and Methods. The clinical, instrumental and biochemical examinations were carried out for 70 patients who had Q-, QS-myocardial infarction (MI) with a ventricular ectopic heartbeat on the regenerative period since the acute coronary syndrome development in 1, 3, and 6 months. The features of the ventricular ectopic heartbeat course in patients with myocardial infarction against the backdrop of sotalol and carvedilol use and influence of applied treatment on the clinical and pathogenetical features of patients’ functional recovery in early and distant (prolonged) postinfarction period were analyzed. Results. Analyzing the dynamics of coronary artery disease clinical manifestations in patients with ventricular arrhythmia (VA) with myocardial infarction against the backdrop of sotalol and carvedilol treatment it has been noted a marked decrease in anginal chest pain manifestation, feeling of palpitations, disruption of the heart, shortness of breath, feeling of breath shortness, etc. in all groups of patients. The positive effect of therapy had been increasing since the 3 week during the 3-month long treatment. Results of heart rate Holter monitoring have shown a marked antiarrhythmic effect of metoprolol, carvedilol and sotalol. In particular, in all groups of patients the frequency of VA reduced by half, the percentage of high grade VA decreased namely pair and group arrhythmia, ventricular bigeminy. Assessment of hemodynamic parameters in the process of patients with ST treatment has represented the marked trend and a further significant increase in ejection fraction and other contractile dysfunction forms correction. This positive trend was the most relevant in the application of carvedilol, a slightly less in patients treated with metoprolol and sotalol. Conclusions. Sotalol in patients after ACS has an ability to reduce the ventricular ectopic heartbeat episodes number and prevents life-threatening arrhythmias, provides a permanent and controlled decrease of heart rate, corrects left ventricle (LV) contractility and processes of postinfarction remodeling of the heart. When using carvedilol it has been noticed a reduction of LV postinfarction remodeling processes, improvement of contractile function of myocardium, antianginal and antiarrhythmic effects, normalization of heart rate variability, reduction of myocardial ischemia, reduction in sudden cardiac death cases. acute coronary syndrome; ventricular premature complexes; ischemic heart disease; myocardial infarction; sotalol; carvedilolhttp://zmj.zsmu.edu.ua/article/view/110086/107058acute coronary syndromeventricular premature complexesischemic heart diseasemyocardial infarctionsotalolcarvedilol
spellingShingle N. M. Kulayets
The Use of β-blockers in Patients with Ventricular Ectopic Heartbeat in the Early and Distant Postinfarction Period
Zaporožskij Medicinskij Žurnal
acute coronary syndrome
ventricular premature complexes
ischemic heart disease
myocardial infarction
sotalol
carvedilol
title The Use of β-blockers in Patients with Ventricular Ectopic Heartbeat in the Early and Distant Postinfarction Period
title_full The Use of β-blockers in Patients with Ventricular Ectopic Heartbeat in the Early and Distant Postinfarction Period
title_fullStr The Use of β-blockers in Patients with Ventricular Ectopic Heartbeat in the Early and Distant Postinfarction Period
title_full_unstemmed The Use of β-blockers in Patients with Ventricular Ectopic Heartbeat in the Early and Distant Postinfarction Period
title_short The Use of β-blockers in Patients with Ventricular Ectopic Heartbeat in the Early and Distant Postinfarction Period
title_sort use of β blockers in patients with ventricular ectopic heartbeat in the early and distant postinfarction period
topic acute coronary syndrome
ventricular premature complexes
ischemic heart disease
myocardial infarction
sotalol
carvedilol
url http://zmj.zsmu.edu.ua/article/view/110086/107058
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