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Capabilities of long-term ECG monitoring in patients with myocardial infarction: the longer, the better?

https://doi.org/10.18705/2311-4495-2022-9-2-27-36

Abstract

Background. In modern cardiology, 24-hour electrocardiogram (ECG) monitoring has a high diagnostic value, but this method has a number of disadvantages in detecting episodes of unstable life-threatening arrhythmias. An increase in ECG monitoring duration allows expanding the possibilities of diagnosing life-threatening arrhythmias.

Objective. To study the possibilities of long-term ECG monitoring (48–120 hours) in the detection of life-threatening arrhythmic events and parameters of myocardial electrical instability in patients with ST-segment elevation myocardial infarction (STEMI).

Design and methods. The study included 71 STEMI patients. All patients from the 4th day of STEMI underwent multi-day ECG monitoring in 3 leads using a telemetric ECG recording complex with an average recording duration of 90.4 ± 30.2 hours. The analysis of episodes of myocardial ischemia, rhythm and conduction disturbances, turbulence and heart rate variability, late ventricular potentials and dispersion of the QT interval within 5 days was carried out.

Results. Long-term monitoring allowed detecting high-grade ventricular extrasystoles. Analysis of episodes of myocardial ischemia in the postinfarction period revealed significant differences in the data of 120h-ECG monitoring in comparison with 24h-ECG. Multiday ECG monitoring made it possible to detect dysfunction of the autonomic regulation of cardiac activity in patients 2 times more often.

Conclusion. A comprehensive assessment of the possibilities of multi-day ECG monitoring is a promising direction in predicting severe arrhythmias in patients in the postinfarction period.

About the Authors

V. E. Oleynikov
Penza State University, Medical Institute
Russian Federation

Valentin E. Oleynikov, DM, Prof., Head of the Department of Therapy

Krasnaya str., 40, Penza, 440026


Competing Interests:

The authors declare no conflict of interest.



E. V. Averyanova
Penza State University, Medical Institute
Russian Federation

Elena V. Averyanova, Ph.D. of Medical Sciences, Associate Professor at the Department of Therapy

Penza


Competing Interests:

The authors declare no conflict of interest.



A. A. Oreshkina
Penza State University, Medical Institute
Russian Federation

Anastasia A. Oreshkina, Роstgraduate student at the Department of Therapy

Penza


Competing Interests:

The authors declare no conflict of interest.



Yu. A. Barmenkova
Penza State University, Medical Institute
Russian Federation

Yulia A. Barmenkova, Ph.D. of Medical Sciences

Penza


Competing Interests:

The authors declare no conflict of interest.



A. V. Kulyutsin
Penza Regional Clinical Hospital N. N. Burdenko
Russian Federation

Aleksey V. Kulyutsin, Ph.D. of Medical Sciences, Associate Professor at the Department of Therapy Medical Institute, Penza State University, Head Department of Cardiology No. 5 with a resuscitation and intensive care

Penza


Competing Interests:

The authors declare no conflict of interest.



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Review

For citations:


Oleynikov V.E., Averyanova E.V., Oreshkina A.A., Barmenkova Yu.A., Kulyutsin A.V. Capabilities of long-term ECG monitoring in patients with myocardial infarction: the longer, the better? Translational Medicine. 2022;9(2):27-36. (In Russ.) https://doi.org/10.18705/2311-4495-2022-9-2-27-36

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ISSN 2311-4495 (Print)
ISSN 2410-5155 (Online)