Inadekvát, aránytalan sinuscsomó-tachycardia: egy régi szívritmuszavar új megvilágításban (II.)

2020 ◽  
Vol 161 (46) ◽  
pp. 1953-1958
Author(s):  
József Borbola ◽  
Csaba Földesi ◽  
Attila Kardos ◽  
Zoltán Som
Keyword(s):  
Quality Of Life ◽  
Heart Rate ◽  
Drug Therapy ◽  
Sinus Node ◽  
Heart Rhythm ◽  
Pharmacological Therapy ◽  
Dynamic Exercise ◽  
Exercise Tests ◽  
Sinus Rate

Összefoglaló. Bevezetés: Az inadekvát, aránytalan sinuscsomó-tachycardia a szív nomotop ingerképzési zavarával járó, nem ritka klinikai szindróma. A szívritmuszavar-entitást a nem paroxysmalis, magas nyugalmi sinusfrekvencia, a fizikai/pszichés stresszre adott aránytalan sinustachycardia, valamint főként palpitációs panaszok jellemzik. Célkitűzés: Az aránytalan sinuscsomó-tachycardiás betegeink gyógyszeres kezelésével szerzett tapasztalataink ismertetése. Módszerek: 2008 és 2018 között 104 beteget (92 nő, 12 férfi; átlagéletkor 31 ± 10 év) kezeltünk ezzel a szívritmuszavarral. A betegek kivizsgálásuk után 12 elvezetéses EKG-, terheléses EKG-, valamint 24 órás Holter-monitoros EKG-megfigyeléseken vettek részt a gyógyszeres kezelés előtt és után (bizoprolol: 2 × 5 mg/nap; ivabradin: 2 × 5 mg/nap). Az életminőség változását a European Heart Rhythm Association (EHRA) tüneti skálája szerint állapítottuk meg. Eredmények: Mindkét gyógyszer jelentősen csökkentette a nyugalmi sinusfrekvenciát (kontroll: 102 ± 10/min; bizoprolol: 78 ± 6/min; ivabradin: 74 ± 8/min, mindkettő: p<0,0001). A gyógyszeres kezelés nélküli, 24 órás Holter-monitoros EKG-felvételek során mért szívfrekvenciák (minimum–maximum [átlag] sinusfrekvencia/min) a kontrollértékekről (58 ± 8–159 ± 14 [94 ± 6]/min) mindkét gyógyszerre egyaránt szignifikánsan csökkentek (bizoprolol: 53 ± 7–132 ± 13 [77 ± 9]/min [mindhárom: p<0,0001]; ivabradin 51 ± 6–134 ± 18 [77 ± 8]/min [mindhárom: p<0,0001]). A terheléses EKG-vizsgálatok előtt (kontroll: 99 ± 13/min; bizoprolol 81 ± 11/min [p<0,0001]; ivabradin: 84 ± 10/min [p<0,0001]) és a terhelés csúcspontján mért sinusfrekvenciák (kontroll: 164 ± 15/min; bizoprolol: 140 ± 16/min [p<0,0001]; ivabradin: 142 ± 14/min [p<0,0001]) is jelentősen mérséklődtek. Az azonos dózisban adott két gyógyszer szívfrekvencia-csökkentő hatásai között számottevő különbséget nem tapasztaltunk. Az életminőséget tükröző EHRA tüneti skálán (kontroll: 2,3 ± 0,7) mind a bizoprolol (1,4 ± 1,4; p<0,0001), mind az ivabradin (1,1 ± 0,2; p<0,0001) egyformán csökkentette a betegek tüneteit, panaszait. Számottevő cardiovascularis mellékhatás egyik betegcsoportban sem jelentkezett. Következtetések: Vizsgálati eredményeink alapján megállapítható, hogy az aránytalan sinuscsomó-tachycardiás betegek gyógyszeres kezelésére: (1) a kardiospecifikus adrenerg béta-blokkoló bizoprolol és az If-csatorna-gátló ivabradin egyaránt hatékonynak és biztonságosnak bizonyult; (2) az azonos adagban adott két gyógyszer hatékonysága között számottevő különbség nem volt; (3) a gyógyszeres kezelés nemcsak a sinusfrekvenciát csökkentette, hanem a betegek panaszait, tüneteit is mérsékelte. Orv Hetil. 2020; 161(46): 1953–1958. Summary. Introduction: The inadequate, inappropriate sinus-node tachycardia is not a rare clinical syndrome, defined as a disturbance of the nomotopic impulse formation of the heart. This cardiac arrhythmic entity is characterized by a non-paroxismal, increased sinus rate at rest, and/or inadequate response to physical and/or emotional stress and palpitations. Objective: The aim of this study was to describe our experiences with pharmacological therapy of patients with inappropriate sinus tachycardia syndrome. Methods: Between 2008 and 2018, 104 patients (92 women, 12 men, mean age: 31 ± 10 years) were treated with this cardiac arrhythmia entity. All patients underwent 12-lead ECG, 24-hour Holter-ECG monitoring and standard bicycle dynamic exercise tests before and after drug treatment (bisoprolol: 5 mg bid; ivabradine: 5 mg bid). Changes in the quality of life were estimated by using the European Heart Rhythm Association (EHRA) score. Results: Both drugs decreased significantly the resting heart rate (control: 102 ± 10/min; bisoprolol 78 ± 6/min (p<0.0001), ivabradine: 74 ± 8/min (p<0.0001). The results of the parameters of the 24-hour Holter ECG recordings (expressed as minimal–maximal [average] heart rate/min) with drug therapy showed a significant decrease from control values in all three parameters: control 58 ± 8–159 ± 14 (94 ± 6)/min; bisoprolol 53 ± 7–132 ±13 (77 ± 9)/min (all three: p<0.0001); ivabradine: 51 ± 6–134 ± 18 (77 ± 8)/min (all three: p<0.0001). The sinus rate reduced significantly both before the bicycle dynamic exercise tests (control: 99 ± 13/min; bisoprolol: 81 ± 11/min [p<0.0001]; ivabradine: 84 ± 10/min [p<0.0001]) and at the peaks of the exercise test (control: 164 ± 15/min; bisoprolol: 140 ± 16/min [p<0.0001]; ivabradine 142 ± 14/min [p<0.0001]). The heart rate reducing effects of the two drugs did not differ significantly. The EHRA quality of life score was equally improved by the two drugs (control: 2.3 ± 0.7; bisoprolol: 1.4 ± 1.4 [p<0.0001]; ivabradine: 1.1 ± 0.2 [p<0.0001]). No cardiovascular side effects were observed while taking bisoprolol or ivabradine. Conclusions: Based on our clinical results, it can be pointed out that in the drug therapy of patients with inappropriate sinus node tachycardia: (1) bisoprolol (5 mg bid) and ivabradine (5 mg bid) proved to be equally effective and safe; (2) the heart rate reducing effect of the two drugs – given in the same dosage – did not differ considerably; (3) the pharmacological therapy significantly decreased not only the sinus frequency, but also reduced the symptoms of the patients. Orv Hetil. 2020; 161(46): 1953–1958.

scholarly journals Inadekvát, aránytalan sinuscsomó-tachycardia. Egy régi szívritmuszavar új megvilágításban

2019 ◽  
Vol 160 (37) ◽  
pp. 1464-1470
Author(s):  
József Borbola ◽  
Csaba Földesi ◽  
Attila Kardos ◽  
Zoltán Som
Keyword(s):  
Quality Of Life ◽  
Heart Rate ◽  
Supraventricular Tachycardia ◽  
Sinus Node ◽  
Holter Monitoring ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Inadequate Response ◽  
X Ray ◽  
Chest X Ray

Abstract: Introduction: The inadequate, inappropriate sinus-node tachycardia is not a rare clinical syndrome, defined as a non-paroxysmal, increased sinus-rate at rest, and/or inadequate response to physical and/or emotional stress, and palpitations. Aim: The aim of this study was to describe our experiences with the investigations of our inappropriate sinus-node tachycardia patients. Method: In the last years, 104 patients (92 women, 12 men, mean age: 31 ± 10 years) were treated with this cardiac arrhythmia entity. All patients underwent 12 leads ECG, chest X-ray, echocardiography, Holter-monitoring and transtelephonic ECG observations. The quality of life score was estimated by using the European Heart Rhythm Association scale. Results: Patients had no structural heart disease (physical examination ECG, chest X-ray, echocardiography were normal), the laboratory values (TSH, blood count) were within normal limits, but the resting heart rates were repeatedly high (102 ± 8/min). The results of Holter recording (expressed as minimal-maximal [average] heart rate/min) without drug therapy showed high heart rate values (59 ± 8, 160 ± 14 [94 ± 6]/min). The standard bicycle ergometry showed an average loading capacity of 124 ± 23 watt (heart rate: control: 99 ± 12/min, top: 167 ± 13/min) with early, inadequate sinus tachycardia. To disclose the episodes of paroxysmal supraventricular tachycardia, beside the Holter-monitoring transtelephonic ECG system was used. This diagnostic modality was very useful for the exclusion of paroxysmal supraventricular tachycardia episodes during the palpitation symptoms. Out of 104 patients, 4 patients (3.8%) showed familiar occurrence, another 16 patients (15.2%) had previous slow-pathway radiofrequency ablation due to atrioventricular nodal reentry tachycardia. Conclusions: Based on our clinical observations, it can be pointed out that inappropriate sinus-node tachycardia syndrome (1) occurs mainly in young women, mostly in students, inducing decreased quality of life scores (EHRA score: 2.3 ± 0.4); (2) the prevalence in our outpatient clinic was 0.7%; (3) the patient population is not homogeneous: familiar or postablation occurrence is possible in some patients; (4) transtelephonic ECG has been proved to be very useful to disclose episodes of paroxysmal supraventricular tachycardia in these patients. Orv Hetil. 2019; 160(37): 1464–1470.

scholarly journals Effectiveness of massage therapy on fatigue and pain in patients with multiple sclerosis: A systematic review and meta-analysis

2021 ◽  
Vol 7 (2) ◽  
pp. 205521732110227
Author(s):  
Shahin Salarvand ◽  
Mohammad Eghbal Heidari ◽  
Kazem Farahi ◽  
Erfan Teymuri ◽  
Mohammad Almasian ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Systematic Review ◽  
Massage Therapy ◽  
Pharmacological Therapy ◽  
Mean Difference ◽  
Cochrane Library ◽  
Clinical Value ◽  
Significant Trial

Background Fatigue and pain are prevalent symptoms of multiple sclerosis (MS) and frequent complaint in MS patients, which reduce their quality of life. This study aimed to assess the effect of massage therapy on pain and fatigue in MS Patients. Method The original and Persian databases were searched included PubMed, web of science, embase, ovid, scopus, and the Cochrane Library, SID, and Iranedex from inception to November 2020. Studies that reported the effect of massage on fatigue and pain were included. Two investigators extracted all relevant data, independently. For deriving analysis, mean difference (MD) and standardized mean difference (SMD) were used. Result Ten studies were eligible acoording criteria. The effect of massage on fatigue showed significant improvement (−1.62; 95% CL −2.40, −0.83; p < .00001), also results of the systematic review showed a significant reduction in pain severity. Conclusion Massage as a complementary and non-pharmacological therapy might have been associated with alleviating fatigue and pain in M.S. patients. Based on the current study, massage intervention for MS patients could have possible clinical value for palliating pain and fatigue and improving quality of life; however, this matter needs further and more significant trial studies.

scholarly journals Phantom Eye Syndrome: A Review of the Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Agda M. Andreotti ◽  
Marcelo C. Goiato ◽  
Eduardo P. Pellizzer ◽  
Aldiéris A. Pesqueira ◽  
Aimée M. Guiotti ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Drug Therapy ◽  
Phantom Pain ◽  
Direct Influence ◽  
Psychological Approach ◽  
Review Of The Literature ◽  
Eye Trauma ◽  
Pubmed Database ◽  
Before And After

The purpose of this literature review was to describe the main features of phantom eye syndrome in relation to their possible causes, symptoms, treatments, and influence of eye amputation on quality of life of anophthalmic patients. For this, a bibliographical research was performed in Pubmed database using the following terms: “eye amputation,” “eye trauma,” “phantom eye syndrome,” “phantom pain,” and “quality of life,” associated or not. Thirteen studies were selected, besides some relevant references contained in the selected manuscripts and other studies hallowed in the literature. Thus, 56 articles were included in this review. The phantom eye syndrome is defined as any sensation reported by the patient with anophthalmia, originated anophthalmic cavity. In phantom eye syndrome, at least one of these three symptoms has to be present: phantom vision, phantom pain, and phantom sensations. This syndrome has a direct influence on the quality of life of the patients, and psychological support is recommended before and after the amputation of the eyeball as well as aid in the treatment of the syndrome. Therefore, it is suggested that, for more effective treatment of phantom eye syndrome, drug therapy should be associated with psychological approach.

Posttransplant Improvement in Heart Rate Variability Correlates with Improved Quality of Life

2000 ◽  
Vol 22 (6) ◽  
pp. 749-768 ◽  
Author(s):  
Donna K. Hathaway ◽  
Mona N. Wicks ◽  
Ann K. Cashion ◽  
Patricia A. Cowan ◽  
E. Jean Milstead ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Rate ◽  
Heart Rate Variability

Valutazione Del Benessere Psico-Fisico Nell’aderenza Terapeutica Nelle Donne Con Malattia Renale Policistica Autosomica Dominante: Uno Studio Osservazionale

2019 ◽  
Vol 31 (3) ◽  
pp. 160-166
Author(s):  
Elena Brioni ◽  
Cristiano Magnaghi ◽  
Giulia Bruna Delli Zotti ◽  
Eleonora Sangiovanni ◽  
Maria Teresa Sciarrone Alibrandi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Blood Pressure ◽  
Kidney Disease ◽  
Educational Intervention ◽  
Water Intake ◽  
Pharmacological Therapy ◽  
Therapeutic Education ◽  
Prospective Longitudinal

BACKGROUND: Autosomal dominant polycystic kidney disease is the most common inherited renal disease and affects less than 1 every 400-1,000 people. There are many effective treatments, including blood pressure management, physical activity, low sodium diet and hydration. Therapeutic education is part of a patient’s care and treatment. This approach is an essential strategy in order to face the current healthcare scenario, in which the number of people affected by chronic diseases is progressively increasing. OBJECTIVES: This article aims to analyze the effect of therapeutic education in patients with ADPKD, the level of adherence to pharmacological therapy and their compliance to dietetic and lifestyle recommendations as part of a nursing-led education. METHODS: This is a prospective, longitudinal, observational pilot study. The following measurements were used: Kidney Disease Quality of life - Short Form, Hospital Anxiety and Depression Scale, Body Uneasiness Test. At the T0 visit, a nurse selected patients and carried out a personalized educational intervention with the aims of adhering to drug therapies, monitoring blood pressure and dietary behavior (physical activity and water intake). At the T1 visit, patients performed psychological tests. At the T2 visit, the following evaluations were performed: a psychological interview together with the delivery and evaluation of the tests performed, an interview with the nurse to evaluate the adherence to the prescriptions, and a control of parameters such as physical activity, diet, water intake, drug therapy, and blood pressure. RESULTS: Therapeutic education can have a positive impact on patients’ health by improving adherence to the pharmacological therapy, diet and lifestyle. CONCLUSIONS: Therapeutic education improve the patient’s knowledge, treatments and correct behaviors as well as promotes an independent management of the disease. Through an educational intervention, the patient acquires the ability and the awareness to modify the wrong behaviors and to guarantee a balance between his needs and the pathology, thus improving the quality of life.

Strengthening the pharmacological potential of drug therapy in treatment of patients with chronic pancreatitis by using therapeutic physical factors

2020 ◽  
pp. 8-14
Author(s):  
R. M. Mallaeva ◽  
A. N. Makhinko ◽  
M. B. Uzdenov
Keyword(s):  
Quality Of Life ◽  
Chronic Pancreatitis ◽  
Drug Therapy ◽  
Clinical Manifestations ◽  
Medical Rehabilitation ◽  
Control Group ◽  
Physical Factors ◽  
Standard Drug ◽  
Pharmacological Potential

The purpose of the study is to improve rehabilitation treatment of patients with chronic pancreatitis (CP) at inpatient stage by strengthening pharmacological potential of drug therapy due to inclusion of therapeutic physical factors (TPF) in therapeutic programs. Materials and methods. 159 patients with acute CP were observed. By simple randomization, 4 groups were formed: the control group (MG, 39 people) received standard drug therapy; 1st comparison group (GC1; 38 people) additionally received TPF; GC2 (40 people) in addition to treatment in GC1 had drinking mineral water «Slavyanovskaya»; in main group (42 people) in addition to the treatment in GC2 got preformed peloidotherapy on the cervical-collar zone. All the patients underwent the evaluation of clinical score and quality of life before and after medical rehabilitation. Results. In MG, clinical symptomatology leveling was by 78,2% (p<0,01), in GC1 — by 71,5% (p<0,01), GC2 — by 62,3% (p<0,01), CG — by 57,2% (p<0,01) on average immediately after the treatment, which was in a clear correlation with indicators of quality of life. In the long term (in 6 and 12 months), the advantage of combination therapy was noted with the same validity, the preservation of the achieved positive result was mostly noted in the MG: after 6 months the improvement in physical health compared to the initial values was noted by 34,4% (p<0,01), after 12 months — by 24,0% (p<0,05); mental — by 32,3% (p<0,01) and 22,5% (p<0,05), respectively. In both comparison groups, positive dynamics was 10–12% lower, and in the control group, after 6 months, there was only a tendency to improve quality of life indicators. Conclusion. The inclusion of TPF in the programs of the inpatient stage of medical rehabilitation of patients with chronic pancreatitis by strengthening the pharmacological potential of drug therapy contributes to the leveling of clinical manifestations (abdominal pain, dyspepsia and diarrhea), the result of which is an improvement in the quality of life of this category of patients.

Abstract 15830: Elevated Resting Heart Rate is Associated With Impaired Quality of Life and Worse NYHA Functional Capacity in Patients With Chronic Heart Failure: Results From REALITY HF Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Yuksel Cavusoglu ◽  
Omer Kozan ◽  
Ahmet Temizhan ◽  
Serdar Kucukoglu
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Heart Rate ◽  
Functional Capacity ◽  
Real Life ◽  
Left Ventricular ◽  
Summary Score ◽  
Treatment Modalities ◽  
Resting Heart Rate

Purpose: Resting heart rate (HR), health related quality of life (HQoL) and NYHA functional capacity are referred as important determinants of prognosis and targets of therapy in heart failure (HF). REALITY HF (Resting Heart Rate and Real Life Treatment Modality in Outpatients with Left Ventricular Systolic Dysfunction) study data were analyzed for the evaluation of any relationship of resting HR with HQoL assessed by Kansas City Cardiomyopathy Questionnaire (KCCQ) and NYHA functional class. Methods: REALITY HF was a multicenter, prospective registry designed to evaluate HF patients’ characteristics and effects of treatment modalities on resting HR and enrolled 1057 patients (age 61±12 years) with LVEF <40%. 781 (74%) patients in sinus rhythm were included in this analysis. Patients were classified into 4 groups according to the quartiles of HR: Q1:<68 bpm (n=234), Q2:69-75 bpm (n=189), Q3:76-87 bpm (n=194) and Q4:>87 bpm (n=164). KCCQ was completed in a random sample of 320 (Q1:n=27, Q2:n=99, Q3:n=125, Q4:n=69) patients, in which higher scores show better patient’s health status. Results: During enrollment, 82% of patients were receiving ≥2 drugs including ACE[[Unable to Display Character: &#304;]]/ARB, beta blocker, aldosterone blocker, diuretic or digoxin. Resting HR was 76±14 bpm and 68% of patients had a resting HR ≥70 bpm. KCCQ overall summary score (OSC) was found to be 75.7±13.2 in those in Q1, 65.5±20.8 in Q2, 64.4±20.6 in Q3 and 58.3±21.2 in Q4 (p=0.004) and KCCQ clinical summary score (CSS) was 80.4±15.7 in those in Q1, 70.0±22.4 in Q2, 69.9±21.9 in Q3 and 63.8±23.3 in Q4 (p=0.016). Also, there was a significant negative correlation between resting HR and OSC (p=0.008) or CSS (p=0.031). The distribution of NYHA-I patients for Q1, Q2, Q3 and Q4 were 40.7%, 22.8%, 23.8% and 12.7%, NYHA-II patients-30.8%, 23.1%, 27.2% and 18.9%, NYHA-III patients-21.2%, 23.9%, 24.3% and 30.6% and NYHA-IV patients-22.7%, 34.1%, 22.7% and 20.5%, respectively (p<0.001). Also, resting HR were found to gradually and significantly increase across NYHA categories (72.8±12 bpm in NYHA-I, 76.1±13 bpm in NYHA-II, 80.2±15 bpm in NYHA-III and 78.9±16 bpm in NYHA-IV, p<0.001). Conclusions: These results suggest that elevated resting HR in HF patients is associated with impaired HQoL and worse NYHA functional capacity.

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