Sex-age features of the prevalence and structure of heart rhythm disorders in the patients with severe Covid-infection

There is growing evidence that arrhythmias are a major complication of COVID-19 infection. Inflammation of the myocardium, cytokine storm, hypoxia, changes of electrolyte levels, coronary vasospasm, microcloths may be factors that contribute to the development of arrhythmias and changes of the ECG. The aim of the study was to determine the sex and age characteristics of the prevalence and structure of cardiac arrhythmias in patients with severe COVID infection. In the study were examined 133 patients with severe COVID-19 infection, who were in the intensive care unit of the city clinical hospital №1 in Vinnytsia at the period from April to December 2020 and as a result of treatment with improved health were discharged from the hospital. Statistical processing of the obtained data was performed using the statistical software package SPSS 12.0 for Windows using parametric and non-parametric methods of statistical analysis. It was found that the most common comorbid pathologies of the patients with severe COVID-19 were – arterial hypertension 90 (67.7%), coronary heart disease 91 (68.4%), chronic heart failure 65 (48.9%), obesity 47 (35.3%) and diabetes mellitus 32 (24.1%). It was found that the prevalence of cardiac arrhythmias in patients with severe COVID-19 was 86 (64.7%) patients. Among all arrhythmias, tachyarrhythmias predominated – 68 (51.1%), in the structure of which sinus tachycardia was the most common in 45 (33.8%) and atrial fibrillation (AF) – in 19 (14.3%) patients, respectively. In turn, sinus tachycardia was significantly more common among women. The prevalence of bradyarrhythmias was 60 (45.1%), in the structure of which were dominated sinus bradycardia 16 (12%) and blockade of the right branch of the His bundle 30 (22.6%). Among men, there was a tendency to the predominance of complete left bundle branch block. The prevalence of ischemic changes and/or repolarization disorders according to the ECG was 119 (89.5%), in the structure of which were dominated the presence of inversion of the T wave 91 (68.4%) and depression of the ST segment 54 (40.6%). The mean age of the patients with ischemic ECG changes was significantly higher compared to patients without signs of repolarization disorders. Among men, there was a predominance of pancreatic hypertrophy and a tendency to predominance of left ventricular hypertrophy.

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Predictors of heart rhythm disorders in the patients with severe COVID-infection

Reports of Vinnytsia National Medical University ◽

10.31393/reports-vnmedical-2020-24(4)-14 ◽

2020 ◽

Vol 24 (4) ◽

pp. 640-646

Author(s):

Y. M. Mostovoy ◽

T. D. Danilevych

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Sinus Bradycardia ◽

Statistical Processing ◽

Heart Rhythm ◽

Careful Examination ◽

Hospital Treatment ◽

St Segment ◽

Heart Rhythm Disorders ◽

The Right

Annotation. The severe course of COVID-19 infection often leads to complications of cardiovascular system. Among them, heart rhythm disorders are one of the main ones requiring careful examination and improvement of management of the patients with COVID-19 infection. The purpose of the work was to establish the probable predictors of cardiac rhythm disorders of the patients with severe COVID infection. In the study were examined 133 patients with severe COVID-19 infection, who were in the intensive care unit of the city clinical hospital №1 in Vinnytsia for 9 months 2020 and as a result of treatment with improved health were discharged from the hospital. Statistical processing of the obtained data was performed using the statistical software package SPSS 12.0 for Windows using parametric and non-parametric methods of statistical analysis. It was found that the prevalence of heart rhythm disorders in patients with severe COVID-19 is 86 (64.7%) patients. The predictors of arrhythmias were: the presence of stroke in anamnesis; acute thrombophlebitis during a hospital treatment; the term of being in the intensive care unit and the overall term of hospitalization. Among all rhythm disorders, tachyarrhythmias were in – 68 (51.1%), sinus tachycardia 45 (33.8%) and atrial fibrillation 19 (14.3%) were dominated in the structure of tachyarrhythmia. There were no significant predictors of tachyarrhythmias. The prevalence of bradyarrhythmias is 60 (45.1%), sinus bradycardia (12%) and the right branch of His bundle block – 30 (22.6%) were prevalent in the structure of bradyarrhythmias. Predictors of the bradyarrhythmias were: the presence of ischemic heart disease (IHD) in anamnesis; acute thrombophlebitis in anamnesis; diseases of the gastrointestinal tract; stroke while staying in a hospital; post-infarction cardiosclerosis; combination of arterial hypertension and IHD; the term of staying in the hospital and in the intensive care unit. Also, ECG predictors of bradyarrhythmia were: depression of the ST segment; pathological Q wave; hypertrophy of the left ventricle; hypertrophy of the right ventricle; extension of QT interval. The prevalence of violations of repolarization according to ECG were in 119 (89.5%) patients, among them the presence of inversion of T wave in 91 (68.4%) and depression of the ST segment – in 54 (40.6%) patients respectively. The predictors of which are: reducing of glomerular filtration rate <60 ml/min/1.73 m2; the duration of hospitalization; the old age of the patients.

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CLINICAL CHARACTERISTICS OF CARDIAC ARRHYTHMIAS IN PREGNANT WOMEN

Wiadomości Lekarskie ◽

10.36740/wlek201903112 ◽

2019 ◽

Vol 72 (3) ◽

pp. 381-383

Author(s):

Oksana I. Afanasiuk ◽

Valentyn I. Shmaliy ◽

Yuliia Yu. Shushkovska

Keyword(s):

Infectious Diseases ◽

Pregnant Women ◽

Structural Damage ◽

Sinus Tachycardia ◽

Sinus Bradycardia ◽

Vena Cava ◽

Heart Rhythm ◽

Perinatal Pathology ◽

Heart Rhythm Disorders ◽

Antiarrhythmic Treatment

Introduction: Cardiac arrhythmia often occurs in the gestational period of pregnant women, contributing to the development of complications of pregnancy, childbirth and perinatal pathology, which requires a more thorough examination of pregnant women and antiarrhythmic treatment, which in turn increases the risk of complications pregnancy and childbirth. Many types of arrhythmias occur in women without structural damage to the cardiovascular system. The aim is to study the occurrence of cardiac rhythm disturbances in healthy pregnant women, depending on the gestational age, the number of previous pregnancies, infectious diseases during pregnancy, and arrhythmia analysis, which required antiarrhythmic treatment. Materials and methods: Retrospectively 60 individual cards of pregnant women were studied. An ECG monitoring was performed to identify the arrhythmia. Results: Among the arrhythmia were: supraventricular and ventricular extrasystoles, unstable paroxysmal tachycardia. All cases of arrhythmia were without lengthening QT interval. Sinus tachycardia was significantly more common in combination with anemia. Heart rhythm disorders are associated with emotional excitement. Conclusions: Most violations of the heart rate occurred in the second trimester of pregnancy. With concomitant anemia, sinus tachycardia is significantly more common, and sinus bradycardia is associated with an enlarged uterus in compression of the inferior vena cava. With the increase in the number of pregnancies, the risk of heart rhythm disturbances increases. However, the past infectious diseases of the bronchopulmonary system during pregnancy did not significantly affect the occurrence of rhythm disturbances. The appointment of antiarrhythmic drugs was observed in all pregnant women whose cards were included in the study.

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Выявление риска жизнеугрожающих нарушений сердечного ритма у детей первого года жизни

Dalʹnevostočnyj medicinskij žurnal ◽

10.35177/1994-5191-2020-2-33-37 ◽

2020 ◽

pp. 33-37

Keyword(s):

Cardiac Arrhythmias ◽

Sinus Tachycardia ◽

Sinus Bradycardia ◽

Heart Rhythm ◽

Healthy Children ◽

Sinus Arrhythmia ◽

Birth Canal ◽

Developing Heart ◽

Life Threatening

To identify the risk of life-threatening heart rhythm disturbances in children in the age group of one year of life, 50 conditionally healthy children at the time of the study were examined. They were divided into 2 groups: 1 group (31 children): children born through the natural birth canal and 2 group – 19 children born using abdominal delivery. The risk of developing various life-threatening cardiac arrhythmias were determined by measuring the index of «electric quality of the heart» according to ECG analysis. As a result of the study, in children of the 1st group, sinus arrhythmia (74 % of children) was most frequently registered, sinus tachycardia (32 %) and sinus bradycardia (26 %) were less common. In the second group ofthe examined patients, sinus arrhythmia was registered in 100 % of cases, sinus bradycardia in 57,9 %, out of which 10 % had pronounced (<5 ‰), sinus tachycardia in 42,1 % of children. We found out that there were no signiﬁcant diﬀerences in the risk of developing life-threatening cardiac arrhythmias according to ECG data in children, depending on the circumstances of the birth. In all the examined children, by determining the index of «electric quality of the heart», the risk of developing heart rhythm disturbance was established, and it was higher in children born from surgical labor: every third child was found to have an average or high risk of developing life-threatening rhythm disturbances.

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Feasibility of remote support for electrophysiological ablation procedures during CoVid-19 pandemics

European Heart Journal ◽

10.1093/eurheartj/ehab724.3110 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

A Muessigbrodt ◽

F Demoniere ◽

S Finoly ◽

M Mommarche ◽

J Inamo

Keyword(s):

Atrial Flutter ◽

Medical Training ◽

Human Life ◽

Heart Rhythm ◽

Left Ventricular ◽

Technical Support ◽

Right Atrial ◽

Global Challenge ◽

Heart Rhythm Disorders ◽

Technical Support Staff

Abstract The COVID-19 pandemics is a global challenge with a huge impact on medicine, politics, economy, education, travel and many other aspects of human life. The treatment of heart rhythm disorders has also been affected by the disease itself and by restrictions in order to constrain the spread of the virus. Catheter ablations of cardiac arrhythmias are nowadays frequently guided by electro-anatomic mapping systems. Technical staff with medical training, or medical staff with technical training, is needed to assist the operator. Travel restrictions due to current COVID-19 pandemics have limited the in person availability for technical support staff. To overcome these limitations we explored the feasibility of remote support with an internet based communication platform. A total of 9 patients (87,5% male, mean age 66,6 years) with different arrhythmias (atrial fibrillation, left atrial flutter, typical right atrial flutter, left ventricular tachycardia), having undergone ablation procedures between October 2020 and February 2021, were included. Acute procedural success was obtained in 9 out of 9 procedures. No complications occurred. Our experience with remote support for electro-anatomic mapping for complex electrophysiological ablation procedures, show the feasibility and safety of this approach. It increases the availability of technical support at reduced costs and a reduced CO2 footprint. Remote support for electro-anatomic mapping may therefore facilitate continuous care for patients with arrhythmias during the COVID-19 pandemics. Due to its advantages beyond COVID-19 pandemics related problems, it will likely play a greater role in the future. FUNDunding Acknowledgement Type of funding sources: None.

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HEART RHYTHM DISORDERS: THE IMPORTANCE OF SYSTEMIC APPROACH

Journal of the Grodno State Medical University ◽

10.25298/2221-8785-2021-19-3-335-343 ◽

2021 ◽

Vol 19 (3) ◽

pp. 335-343

Author(s):

V. A. Snezhitskiy ◽

◽

L. V. Kalatsei ◽

Keyword(s):

Physical Examination ◽

Cardiac Arrhythmias ◽

Rapid Development ◽

Heart Rhythm ◽

Systemic Approach ◽

Literature Analysis ◽

History Taking ◽

Conduction Disorders ◽

Heart Rhythm Disorders ◽

Instrumental Methods

Despite the rapid development of complex instrumental methods of diagnosis of rhythm and conduction disorders, careful history taking and physical examination do not lose their relevance and significance. Based on the literature analysis, this article reflects the methodology of complaints and history taking, and physical examination in patients with cardiac arrhythmias. Particular attention is paid to the importance of a systemic approach to the clinical examination of patients, which allows not only to suspect the presence of cardiac arrhythmias before recording an electrocardiogram, but also to suggest their character and features, which sets the direction for subsequent diagnostic search.

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Post-COVID-19 syndrome: morpho-functional abnormalities of the heart and arrhythmias

Russian Journal of Cardiology ◽

10.15829/1560-4071-2021-4485 ◽

2021 ◽

Vol 26 (7) ◽

pp. 4485

Author(s):

M. V. Chistyakova ◽

D. N. Zaitsev ◽

A. V. Govorin ◽

N. A. Medvedeva ◽

A. A. Kurokhtina

Keyword(s):

Pulmonary Artery ◽

Right Ventricular ◽

Cardiac Arrhythmias ◽

Myocardial Strain ◽

Left Ventricular ◽

Upper Respiratory Tract ◽

Regional Strain ◽

Group 3 ◽

The Right ◽

Group 1

Aim. To study the myocardial morpho-functional abnormalities, the incidence and nature of cardiac arrhythmias in patients 3 months after the coronavirus disease 2019 (COVID-19).Material and methods. The study included 77 patients (mean age, 35,9 years) treated for coronavirus infection, which underwent echocardiography and 24-hour Holter monitoring 3 months after COVID-19. The patients were divided into 3 groups: group 1 — 31 patients with upper respiratory tract involvement; group 2 — 27 patients with bilateral pneumonia (CT grade 1, 2), 3 — 19 patients with severe pneumonia (CT grade 3, 4). Statistical processing was carried out using Statistica 10.0.Results. According to echocardiography, the peak tricuspid late diastolic velocity and isovolumetric contraction time in all groups increased (P<0,001). The tricuspid and mitral Em/Am ratio decreased depending on the disease severity. In group 3, the right ventricular and atrial size increased (P<0,001). The pulmonary artery systolic pressure, left atrial volume in patients of the 2nd and 3rd groups was higher than in the control one (P<0,001). In group 1 and 2 patients, the regional strain in basal and basal/middle segments decreased, respectively, while, in group 3, not only regional but also global left ventricular (LV) strain decreased (P<0,001). In all groups, cardiac arrhythmias and pericardial effusion were found. The relationship was established between coronavirus activity and the structural and functional myocardial parameters (P<0,001).Conclusion. Cardiovascular injury 3 months after COVID-19 was found in 71%, 93%, and 95% of patients with mild, moderate and severe course. In mild course patients, a decrease in regional myocardial strain in LV basal segments, signs of past pericarditis, and various cardiac arrhythmias were noted. In patients of moderate severity, these changes were more pronounced and were accompanied by an additional decrease in regional strain in LV middle segments, impaired right ventricular diastole and increased pulmonary artery pressure. In severe patients, in addition to the above changes, dilatation of the right heart and inferior vena cava was recorded, as well as LV diastolic and global systolic function decreased.

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ABOUT THE ALLOCATION OF MENTAL DISORDERS RISK GROUPS IN THE PRACTICE OF CARDIOLOGY DEPARTMENT

Acta biomedica scientifica ◽

10.12737/article_5a3a0e794aff80.62275471 ◽

2018 ◽

Vol 2 (5) ◽

pp. 114-120 ◽

Cited By ~ 1

Author(s):

Мария Дорофейкова ◽

Mariia Dorofeikova ◽

Сергей Задворьев ◽

Sergey Zadvorev ◽

Наталия Петрова ◽

...

Keyword(s):

Mental Disorders ◽

Cardiac Arrhythmias ◽

Emotional State ◽

Heart Rhythm ◽

Female Gender ◽

Risk Groups ◽

Cardiology Department ◽

Heart Rhythm Disorders ◽

Paroxysmal Hypertension ◽

Emotional Condition

Differential diagnosis of somatic and somatoform pathology is a pressing issue in general practice. The aim of this study was to develop an algorithm for identification of the patients with indications for psychiatrist’s consultation and possible psychotropic therapy at the stage of admission to multi-disciplinary hospital. Material and methods. Regression analysis of data of 1031 patient hospitalized in the cardiology department of a multiprofile hospital was done with the aim of identifying factors determining the recommendation for receiving psychotropic therapy at discharge. Results. An algorithm for allocation among patients of cardiological profile individuals that require a multidisciplinary approach to treatment involving experts in the field of mental health is proposed. Factors included in the formula were labile or paroxysmal hypertension, the number of associated (non-cardiological) diagnosis, female gender and heart rate or heart rhythm disorders with the debut at the age below 55 or 50 years: I = 8 × L + D + 3 × F + 3 (6) × H. Conclusion. The revealed pattern may be useful in the clinic of internal diseases for screening of patients with a high contribution of the emotional state the severity of the condition. The doctors of the hospitals of somatic (therapeutic) profile should pay more attention to the psycho-emotional condition of patients with labile hypertension, early onset of cardiac arrhythmias, and large number of comorbidities. Patients that meet the criteria are likely to need a consultation of a psychotherapist or psychiatrist because of the presence of psychosomatic or other mental disorders.

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Clinical and laboratory associations of liver fibrosis indexes in patients with decompensated Chronic Heart Failure II-IV Functional Classes

Kardiologiia ◽

10.18087/cardio.2020.5.n920 ◽

2020 ◽

Vol 60 (5) ◽

pp. 90-99

Author(s):

S. K. Stolbova ◽

N. A. Dragomiretskaya ◽

I. G. Beliaev ◽

V. I. Podzolkov

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Liver Fibrosis ◽

Hepatic Fibrosis ◽

Heart Rhythm ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

Heart Rhythm Disorders ◽

High Liver

Aim To study clinical and laboratory associations of hepatic fibrosis indexes in patients with decompensated NYHA functional class II-IV chronic heart failure (CHF).Material and methods The study included 128 patients admitted to the cardiological or therapeutic department of the University Clinical Hospital #4 at the I. M. Sechenov First Moscow State Medical University (Sechenov University) with symptoms of CHF associated with ischemic heart disease (IHD) and/or arterial hypertension (AH). All patients had signs of liver disease (liver enlargement on physical examination ± diffuse changes in hepatic tissue according to ultrasound data). Mean age was 70.59±10.71 years. Along with general clinical examination, severity of hepatic fibrosis was evaluated by calculated indexes, FIB-4, APRI, MELD-XI, and BARD. All calculations were based on laboratory data obtained within the first two days of hospitalization for decompensated CHF, at the onset of active therapy with intravenous diuretics. Statistical analyses were performed with the R programming language (3.6.1).Results In patients with NYHA FC II–IV CHF, the FIB-4 index significantly increased with the increase in NYHA FC (р<0.05). Also, the high liver density by most fibrosis indexes correlated with the probability of LV EF decrease to <40 % (FIB-4: RR, 1.32 at 95 % CI from 0.53 to 3.28, р=0.079; MELD-XI: RR, 1.62 at 95 % CI from 1.19 to 2.20, р=0.004; BARD: median LV EF, 42.5 % vs. 56 %, р=0.019), and a tendency to heart rhythm disorders was observed (FIB-4: RR, 1.92 at 95 % CI from 0.75 to 4.90, р=0.218; BARD: RR, 1.09 at 95 % CI from 0.97 to 1.22, р=0.174; MELD-XI: RR, 1.34 at 95 % CI from 0.94 to 1.90, р=0.101). Increases in liver fibrosis indexes correlated with other multiorgan disorders in CHF patients evident as a decrease in platelet count (FIB-4: р<0.01; APRI: р=0.045) and a tendency to a decrease in hemoglobin (FIB-4: 127 g/l vs. 137 g/l, p=0.249; APRI: 127 g/l vs. 136 g/l, p=0.749). Patients with a high liver density more frequently had cardiorenal syndrome diagnosed by reduced glomerular filtration rate (GFR) estimated by CKD-EPI to less than 60 ml/min / 1.73 m2 (FIB-4: р<0.03; MELD-XI: p=0.0001; BARD: р=0.005). In comparing liver fibrosis indexes in subgroups of CHF patients with preserved and reduced left ventricular ejection fraction (LV EF), significant differences were found only for MELD-XI (12.08 vs. 9.32, р=0.001).Conclusions For all studied indexes, correlations were observed with LV EF, decreases in hemoglobin, and incidence of heart rhythm disorders. For the BARD, FIB-4, and MELD-XI indexes, high results of calculations correlated with the presence of other predictors for unfavorable prognosis and disease severity (LV EF, NYHA FC, presence of type 2 diabetes mellitus, chronic kidney disease, and lower GFR). Liver fibrosis indexes are a new and promising but understudied instrument for evaluation of prognosis in CHF patients, which requires further study to determine most appropriate prognostic formulas.

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A paradigm shift in the concept of arrhythmogenic cardiomyopathy: expanding the clinical and genetic spectrum, new diagnostic criteria for left ventricular phenotypes

Russian Journal of Cardiology ◽

10.15829/1560-4071-2020-3863 ◽

2020 ◽

Vol 25 (10) ◽

pp. 3863

Author(s):

T. G. Vaikhanskaya ◽

L. N. Sivitskaya ◽

T. V. Kurushko ◽

T. V. Rusak ◽

O. D. Levdansky ◽

...

Keyword(s):

Genetic Diseases ◽

Diagnostic Algorithm ◽

Heart Rhythm ◽

Practical Experience ◽

Left Ventricular ◽

High Tech ◽

Arrhythmogenic Cardiomyopathy ◽

Multicenter Studies ◽

Plakophilin 2 ◽

The Right

Recent multicenter studies using high-tech cardiac imaging and novel translational technologies have shown that cardiac fibrofatty replacement, characteristic of arrhythmogenic cardiomyopathy (ACM), is observed in both ventricles; left ventricular (LV) involvement may be minimal, on par with the right ventricle (RV), or dominant. In 2019, the Heart Rhythm Society (HRS) proposed a new approach to the assessment of arrhythmic and genetic diseases with the inclusion of new phenotypes — left-dominant ACM and biventricular ACM. In 2020, to improve the diagnosis of left ventricular phenotypes, European experts revised ACM criteria (based on the 2010 ITF criteria), which are called the Padua criteria.The presented article highlights the clinical and genetic aspects of the new concept and the difficulties in ACM diagnosis, the practical experience of using new diagnostic algorithm. To help practitioners, step-by-step differential diagnosis and risk stratification of right and left ventricular phenotypes are presented using clinical examples (leftdominant ACM with a pathogenic variant in the LMNA gene; right-dominant ACM associated with a desmoplakin gene mutation, with predominant RV and moderate LV involvement; and an isolated RV ACM associated with a mutation in the plakophilin 2 gene).

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Fabry’s disease in cardiological aspect

Medical alphabet ◽

10.33667/2078-5631-2020-7-22-27 ◽

2020 ◽

pp. 22-27

Author(s):

L. D. Khidirova ◽

A. Kh. Magomedova ◽

A. A. Vasilenko ◽

V. S. Dudchenko

Keyword(s):

Subsequent Development ◽

Heart Rhythm ◽

Cardiovascular Complications ◽

Left Ventricular ◽

Fabry’S Disease ◽

Fabry's Disease ◽

Enzyme Replacement ◽

Heart Rhythm Disorders ◽

Lysosomal Accumulation ◽

Gla Gene

Hereditary genetic X-linked disease Fabry’s disease belongs to the group of lysosomal accumulation diseases and is caused by mutations in the GLA gene and is characterized by a decrease in functional activity or complete absence of the enzyme α-galactosidase A. This pathology belongs to the group of orphan diseases. Mutation of the GLA gene leads to the formation of defective forms of the enzyme α-galactosidase A, which contributes to the violation of the catabolism of glycosphingolipids, their further accumulation in the lysosomes of various cell cultures, and the development of lysosomal cell dysfunction. The prevalence of Fabry disease is about 1 in 117,000 live-born boys. According to screening studies in newborns, this figure can be about 1 in 3,100 and affects to the same extent representatives of all ethnic groups. Fabri’s disease has become actively studied in Russia, but more than 5,000 people (according to estimates) remain undiagnosed. In the first place among the causes of death in Fabry’s disease is heart disease, in particular left ventricular hypertrophy with the subsequent development of diastolic dysfunction and heart failure. Heart rhythm disorders are often observed. Early diagnosis of Fabri disease will lead to the appointment of genotype-specific enzyme replacement therapy and reduce the risk of cardiovascular complications.

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