transmedТрансляционная медицинаTranslational Medicine2311-44952410-5155Almazov National Medical Research Centre, Saint Petersburg, Russia10.18705/2311-4495-2018-5-4-44-52transmed-429Research ArticleСЕРДЕЧНО-СОСУДИСТЫЕ ЗАБОЛЕВАНИЯCARDIOVASCULAR MEDICINEИзменения процессов деполяризации желудочковой экстрасистолы у пациентов с аритмогенной кардиомиопатией/ дисплазией правого желудочка: фрагментация и максимальная продолжительность экстрасистолического комплекса QRSСhanges in depolarization processes of ventricular extrasystole in patients with arrhythmogenic cardiomyopathy/right ventricular dysplasia: fragmentation and maximum duration of QRS complexЗемсковИ. А.ZemskovI. A.

Земсков Иван Александрович - аспирант, НИЛ электрокардиологии ФГБУ.

Ул. Аккуратова, д. 2, Санкт-Петербург, 197341

Ivan A. Zemskov - postgraduate student, electrocardiology research department.

Akkuratova str. 2, Saint Petersburg, 19734

medic73@yandex.ruПармонЕ. В.ParmonE. V.

Пармон Елена Валерьевна - кандидат медицинских наук, доцент, НИЛ электрокардиологии, директор института медицинского образования.

Elena V. Parmon - PhD, Associate Professor, electrocardiology research department, director of the Institute of Medical Education.

Akkuratova str. 2, Saint Petersburg, 19734

Федеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр им. В.А. Алмазова» Минздрава РоссииРоссияAlmazov National Medical Research CentreRussian Federation201830092018544452Copyright © Земсков И.А., Пармон Е.В., 20182018Земсков И.А., Пармон Е.В.Zemskov I.A., Parmon E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://transmed.almazovcentre.ru/jour/article/view/429Актуальность

Актуальность: Помимо известных риск-стратификационных маркеров желудочковой экстрасистолы (ЖЭ), таких как частота и морфология, имеются ее новые характеристики: максимальная продолжительность интервала QRS (VEQSI max.) ЖЭ и ее фрагментация (fQRS), которые недостаточно изучены у пациентов с АК/ДПЖ.

Цель

Цель: Проанализировать VEQSI max. и fQRS у пациентов с АК/ДПЖ и определить их взаимосвязь с частотой ВСС, синкопами, имплантацией и срабатыванием ИКД. Материалы и методы: Включено 83 пациента (41 м., 30.3±4.1 года): 55 (27 м.) с уточненным диагнозом АК/ДПЖ, 13 (5 м.) — пограничным, 15 (9 м.) — возможным.

Результаты

Результаты: Синкопы возникали у 34 пациентов (41,0%, 19 м.): преимущественно (70,5%) при уточненном диагнозе (УД). ВСС — у 5 пациентов (2,4%, 4 м.), из них у 4-х (80,0%) с УД. ИКД имплантирован 31 пациенту (37,3%, 21 м.), среди них 27 (87,1%, 18 м.) — с УД, срабатывание ИКД произошло у 15 пациентов (48,4%, 11 м.) с УД. VEQSI max. приУД оказался достоверно выше, чем при других вариантах (р<0,05), и выше у мужчин (р<0,05). FQRS наиболее часто выявлялся припри уточнённом (0,8%) и возможном (13,3%) диагнозе, в отведениях II, III, V5-V6. Заключение: Синкопы, ВСС, имплантация и срабатывание ИКД возникали чаще у пациентов с уточнённым диагнозом АК/ДПЖ, у таких пациентов был выше показатель VEQSI max.

Background

Background: There are new characteristics of ventricular extrasystole (VE): the QRS interval maximum duration (VEQSI max.) and its fragmentation (fQRS), which are insufficiently studied in patients with ARVD/C.

Objective

Objective: To analyze VEQSI max. and fQRS of VE depending on frequency of SCD, syncope, ICD and ICD-shocks in patients with ARVD/C.

Materials and methods

Materials and methods: Included 83 patients:(41 m, 30.3±4.1 years): 55 (27 m) with the established (ED), 13 (5 m) — borderline, 15 (9 m) — possible diagnosis of ARVD/C [Marcus F.I., 2010].

Results

Results: Syncope were in 34 patients (41,0%, 19 m): mostly (70,5%, 15 m) in the ED. SCD — in 5 patients (2,4%, 4 m): 80,0% with the ED. ICD was implanted to 31 patients (37,3%, 21 m) in 87,1% ED. ICDshocks- in 15 patients (48,4%,11 m) with the ED. The average VEQSI max was 168,1±23,1ms, significantly higher inED (р<0,05), and in men (р<0,05). FQRS was discovered in ED (10,8%) and possible diagnosis (13,3%), in the leads II, III, V5-V6.

Conclusions

Conclusions: Syncope, SCD, ICD implanting and shocks were occurred more often in patients with the established diagnosis of ARVD/C. VEQSI max. was higher in that group.

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The authors declare that there are no conflicts of interest present.