Choice of ventricular arrhythmia therapy in coronary artery disease
Aim. To study trigger factors of ventricular arrhythmias (VA) in patients with stable coronary artery disease (CAD) and evaluate the effectiveness of individualized treatment.Material and methods. The study included 155 patients with CAD aged 36 to 83 years (61,5±9,8 years); 73,5% were men with freq...
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«FIRMA «SILICEA» LLC
2020-08-01
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| Series: | Российский кардиологический журнал |
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| Online Access: | https://russjcardiol.elpub.ru/jour/article/view/3707 |
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| author | A. A. Tatarinova E. A. Ryngach T. V. Treshkur |
| author_facet | A. A. Tatarinova E. A. Ryngach T. V. Treshkur |
| author_sort | A. A. Tatarinova |
| collection | DOAJ |
| description | Aim. To study trigger factors of ventricular arrhythmias (VA) in patients with stable coronary artery disease (CAD) and evaluate the effectiveness of individualized treatment.Material and methods. The study included 155 patients with CAD aged 36 to 83 years (61,5±9,8 years); 73,5% were men with frequent single and coupled ventricular ectopic complexes (VEC) and the left ventricle ejection fraction (LVEF) of 56,4±8,5%. Exclusion criteria were class IV angina, acute coronary syndrome, LV aneurysm, LVEF ≤45%. Treatment and examination of patients was carried out according to the algorithm we proposed in 2017 for managing patients with CAD and high-grade VA.Results. Depending on association between ventricular ectopy and transient myocardial ischemia (TMI) during an exercise tolerance test, patients were divided into 2 groups. Group I included 84 patients (54,2%) with ischemic VA. According to noninvasive topical diagnostics, the arrhythmogenic focus in all patients with ischemic VA was located in the left ventricle. Group II consisted of 71 (45,8%) patients with nonischemic VA, and two subgroups were distinguished depending on presence/absence of TMI: 2A and 2B. During the exercise test, several types of VA were identified.Myocardial revascularization (MR) was indicated in 84,5% of cases in both groups. Six months after MR in group I, the antiarrhythmic effect (AAE) was observed in 55 (77,5%) patients. In group IIA, AAE was significantly lower at 61,7% (p=0,048). We also revealed anxiety in 15 patients of group II. Anxiolytic therapy showed AAE in 75% of group IIA patients and in 63,6% of group IIB patients. Nine patients of group II were referred to radiofrequency ablation of VA with a positive effect of 55,5%. Antiarrhythmic drugs (amiodarone, sotalol) were taken by 5 people of group I.Conclusion. The search for trigger factors and their elimination provides a high AAE for VA therapy in patients with CAD. |
| format | Article |
| id | doaj-art-148b1848df894861ba62e1430b787c4d |
| institution | DOAJ |
| issn | 1560-4071 2618-7620 |
| language | Russian |
| publishDate | 2020-08-01 |
| publisher | «FIRMA «SILICEA» LLC |
| record_format | Article |
| series | Российский кардиологический журнал |
| spelling | doaj-art-148b1848df894861ba62e1430b787c4d2025-08-20T02:59:07Zrus«FIRMA «SILICEA» LLCРоссийский кардиологический журнал1560-40712618-76202020-08-0125710.15829/1560-4071-2020-37072889Choice of ventricular arrhythmia therapy in coronary artery diseaseA. A. Tatarinova0E. A. Ryngach1T. V. Treshkur2Almazov National Medical Research CenterAlmazov National Medical Research CenterAlmazov National Medical Research CenterAim. To study trigger factors of ventricular arrhythmias (VA) in patients with stable coronary artery disease (CAD) and evaluate the effectiveness of individualized treatment.Material and methods. The study included 155 patients with CAD aged 36 to 83 years (61,5±9,8 years); 73,5% were men with frequent single and coupled ventricular ectopic complexes (VEC) and the left ventricle ejection fraction (LVEF) of 56,4±8,5%. Exclusion criteria were class IV angina, acute coronary syndrome, LV aneurysm, LVEF ≤45%. Treatment and examination of patients was carried out according to the algorithm we proposed in 2017 for managing patients with CAD and high-grade VA.Results. Depending on association between ventricular ectopy and transient myocardial ischemia (TMI) during an exercise tolerance test, patients were divided into 2 groups. Group I included 84 patients (54,2%) with ischemic VA. According to noninvasive topical diagnostics, the arrhythmogenic focus in all patients with ischemic VA was located in the left ventricle. Group II consisted of 71 (45,8%) patients with nonischemic VA, and two subgroups were distinguished depending on presence/absence of TMI: 2A and 2B. During the exercise test, several types of VA were identified.Myocardial revascularization (MR) was indicated in 84,5% of cases in both groups. Six months after MR in group I, the antiarrhythmic effect (AAE) was observed in 55 (77,5%) patients. In group IIA, AAE was significantly lower at 61,7% (p=0,048). We also revealed anxiety in 15 patients of group II. Anxiolytic therapy showed AAE in 75% of group IIA patients and in 63,6% of group IIB patients. Nine patients of group II were referred to radiofrequency ablation of VA with a positive effect of 55,5%. Antiarrhythmic drugs (amiodarone, sotalol) were taken by 5 people of group I.Conclusion. The search for trigger factors and their elimination provides a high AAE for VA therapy in patients with CAD.https://russjcardiol.elpub.ru/jour/article/view/3707ventricular arrhythmiasischemiaexercise tolerance testantiarrhythmic effectmyocardial revascularization |
| spellingShingle | A. A. Tatarinova E. A. Ryngach T. V. Treshkur Choice of ventricular arrhythmia therapy in coronary artery disease Российский кардиологический журнал ventricular arrhythmias ischemia exercise tolerance test antiarrhythmic effect myocardial revascularization |
| title | Choice of ventricular arrhythmia therapy in coronary artery disease |
| title_full | Choice of ventricular arrhythmia therapy in coronary artery disease |
| title_fullStr | Choice of ventricular arrhythmia therapy in coronary artery disease |
| title_full_unstemmed | Choice of ventricular arrhythmia therapy in coronary artery disease |
| title_short | Choice of ventricular arrhythmia therapy in coronary artery disease |
| title_sort | choice of ventricular arrhythmia therapy in coronary artery disease |
| topic | ventricular arrhythmias ischemia exercise tolerance test antiarrhythmic effect myocardial revascularization |
| url | https://russjcardiol.elpub.ru/jour/article/view/3707 |
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