VENTRICULAR ARRHYTHMIAS THE IMPACT OF THE QUALITY OF LIFE OF PATIENTS

Abstract

Ventricular arrhythmias are quite often recorded in people without structural pathology of the heart. The application of current recommendations for the management of such patients in real practice has a number of objective and subjective limitations. In this regard, further studies aimed at clarifying the indications for the use of various treatment methods are relevant. The aim of the study is to study the immediate results of various approaches to the treatment of frequent ventricular extrasystole (IE) and/or ventricular tachycardia (VT) in individuals without structural heart pathology. Material and methods. The study included 85 patients (21 men and 64 women; average age 44 [32; 56] years) with ventricular arrhythmias in the absence of structural pathology of the heart. The average number of RE per day was 15,251 [8979; 23,642], unstable VT was registered in 26 patients, stable VT in 5. Further management tactics were determined taking into account the patient's preferences: 27 (32%) preferred performing an RF focus of arrhythmia, 37 (43%) — antiarrhythmic therapy (AAT), 21 (25%) — dynamic observation without treatment. Initially and after 1 month Holter electrocardiogram monitoring and quality of life (QOL) assessment were performed using a questionnaire SF-36. Results. The results of RFA and AAT were comparable (p>0.1): after 1 month, the criteria for a positive antiarrhythmic effect were noted in 74.1% of patients in the RFA group, in 67.6% from the AAT group and in 38.1% from the follow—up group. Initially, the quality of life of patients in the subgroups of RFA and AAT did not differ significantly. At the same time, the quality of life of those who chose a wait-and-see tactic was significantly higher compared to patients from the RF groups and AAT (p=0.033). After 1 month after effective RF, QOL improved statistically significantly. If the procedure is ineffective, on the contrary, a decrease in the average score on the mental health scale (p=0.034) was revealed. In the AAT subgroup, the most often positive effect was achieved against the background of taking the antiarrhythmic IC class etacizine (69.7%), and side effects were less likely to occur during treatment with beta-blockers (8.5%). After 1 month, in patients with effective therapy, QOL indicators significantly improved, and with the ineffectiveness of AAT, they changed statistically insignificantly. In the group after 1 month of observation, none of the indicators of QOL changed significantly. However, in 8 patients with a spontaneous decrease in the number of RE, there was a significant increase in the average score on the mental health scale (p=0.024).