Difficulties in diagnostics of ventricular parasystoly in clinical practice
E.V. KHAZOVA1, M.I. MALKOVA1,2, O.V. BULASHOVA1, V.N. OSLOPOV1
1Kazan State Medical University of the Ministry of Health of the Russian Federation, Kazan
2Municipal Clinical Hospital №7, Kazan
Contact:
Khazova E.V. ― PhD (medicine), Associate Professor of the Department of Propedeutics of Internal Diseases named after Prof. S.S. Zimnitskiy
Address: 49 Butlerov Str., Kazan, Russian Federation, 420012, e-mail: [email protected]
The article describes incidence and factors of parasystoly. Classical signs of parasystoly are described, as well as possible types of competitive pacemaking. Examples of ECG signs of parasystoly are given as a result of Holter monitoring (authors’ data). Ambiguous opinions are presented about the prognostic value of revealing parasystoly in patients with and without organic heart lesions. The data on the parasystoly influence on the prognosis and provoking of ventricular fibrillation in myocardiac infarction patients are still uncertain. Authors’ observation of a patient with rhythm disorder ― ventricular parasystoly ― is presented. A series of daily ECG monitoring (2016-2019) shows the dynamics of rhythm violations: increase of ventricular ectopic activity, transition of paroxysmal atrium fibrillations into constant form.
Key words: parasystoly, heart pace disorder, Holter monitoring of ECG.
(For citation: Khazova E.V., Malkova M.I., Bulashova O.V., Oslopov V.N. Difficulties in diagnostics of ventricular parasystoly in clinical practice. Practical medicine. 2020. Vol. 18, №1, P. 18-25 )
REFERENCES
- Epstein A.E., Bigger J.T., Wyse D.S. et al. Events in the Cardiac Arrhythmia Suppression Trial (CAST): mortality in the entire population enrolled. J. Am. Coll Cardiol, 1991, no. 18, pp. 14-19.
- Gallavardin L. Extrasystolic ventriqular a paroysmes tachycardiques prolonges. Arch. Mal Coeur Vaiss, 1922, no. 15, pp. 298-306.
- Apshtein A.E., Ideker R.E. Ventricular Fibrillation in “Cardiac Electrophysiology. From Cell to Bedside”, ed. By Zipes D.P. and Jalife J., W.B. Saunders Company, 2000. Pp. 677-684.
- Kaufmann R., Rothberger C.J. Beitra ̈gezurentstehungsweise extrasystolis cherallorhythmien. Z. Gesamte Exp. Med, 1919, no. 9, pp. 104-22.
- Kinoshita S., Mitsuoka T. Effekt of standing on ventricular parasystole: shortening of the parasystolic cycle length. Heart, 1997, no. 77, pp. 133-137.
- Kinoshita S., Oyama Y., Kawasaki H. Effects of exercise and standing on atrial parasystole: prolongation and shortening cycle length. J. Elektrocardiol, 1999, no. 32 (4), rr. 365-9.
- Kovaleva L.I., Paleev N.R., Vinogradova T.S. Nikiforova T.B. Differential diagnosis of coupled type parasystole and extrasystole. Kardiologiya, 1984, no. 1, pp. 51-56 (in Russ.).
- Belyalov F.I. Aritmii serdtsa: monografiya; izd. 5, pererab. i dop. [Cardiac arrhythmias: monograph; ed. 5, rev. and add.]. Irkutsk: RIO IMAPO, 2011. 333 p.
- Zipes D.P., Camm A.J., Borggrefe M. et al. ACC/AHA/ESC 2006 Guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Circulation, 2006, vol. 114, pp. e385-e484.
- Priori S.G., Blomstrm-Lundqvist C., Mazzanti A. et al. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac Death. The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology. Eur. Heart J, 2015, no. 36 (41), pp. 2793-867.
- Kushakovskiy M.S., Treshkur T.V. On accelerated parasystolic rhythms and parasystolic tachycardia. Vestnik aritmologii, 1994, no. 2, pp. 46-52 (in Russ.).
- Treshkur T.V. Electrocardiographic features of automatic idioventricular rhythms. Vestnik aritmologii, 2004, no. 38, pp. 68-74 (in Russ.).
- Treshkur T.V. Clinical and electrocardiographic analysis of accelerated idioventricular rhythms. Rossiyskiy kardiologicheskiy zhurnal, 2015, vol. 20, no. 12, pp. 37-44 (in Russ.).
- Doshchitsin V.L. Lechenie aritmiy serdtsa [Treatment of cardiac arrhythmias]. Moscow, 1993. 320 p.
- Kechker M.I., Lebedeva E.L. Antiarrhythmic effect of trimetazidine in patients with coronary heart disease with extrasystole and parasystole. Vestnik aritmologii, 2003, no. 31, pp. 26-31 (in Russ.).