The Use of β-blockers in Patients with Ventricular Ectopic Heartbeat in the Early and Distant Postinfarction Period
DOI:
https://doi.org/10.14739/2310-1210.2017.5.110086Keywords:
acute coronary syndrome, ventricular premature complexes, ischemic heart disease, myocardial infarction, sotalol, carvedilolAbstract
Aim: to increase the effectiveness of patients after Q-, QS- myocardial infarction rehabilitation, based on the study of clinical, instrumental and biochemical changes in cases of cardiac arrhythmias, and development on this basis of new approaches to treatment.
Materials and Methods. The clinical, instrumental and biochemical examinations were carried out for 70 patients who had Q-, QS-myocardial infarction (MI) with a ventricular ectopic heartbeat on the regenerative period since the acute coronary syndrome development in 1, 3, and 6 months. The features of the ventricular ectopic heartbeat course in patients with myocardial infarction against the backdrop of sotalol and carvedilol use and influence of applied treatment on the clinical and pathogenetical features of patients’ functional recovery in early and distant (prolonged) postinfarction period were analyzed.
Results. Analyzing the dynamics of coronary artery disease clinical manifestations in patients with ventricular arrhythmia (VA) with myocardial infarction against the backdrop of sotalol and carvedilol treatment it has been noted a marked decrease in anginal chest pain manifestation, feeling of palpitations, disruption of the heart, shortness of breath, feeling of breath shortness, etc. in all groups of patients. The positive effect of therapy had been increasing since the 3 week during the 3-month long treatment. Results of heart rate Holter monitoring have shown a marked antiarrhythmic effect of metoprolol, carvedilol and sotalol. In particular, in all groups of patients the frequency of VA reduced by half, the percentage of high grade VA decreased namely pair and group arrhythmia, ventricular bigeminy. Assessment of hemodynamic parameters in the process of patients with ST treatment has represented the marked trend and a further significant increase in ejection fraction and other contractile dysfunction forms correction. This positive trend was the most relevant in the application of carvedilol, a slightly less in patients treated with metoprolol and sotalol.
Conclusions. Sotalol in patients after ACS has an ability to reduce the ventricular ectopic heartbeat episodes number and prevents life-threatening arrhythmias, provides a permanent and controlled decrease of heart rate, corrects left ventricle (LV) contractility and processes of postinfarction remodeling of the heart. When using carvedilol it has been noticed a reduction of LV postinfarction remodeling processes, improvement of contractile function of myocardium, antianginal and antiarrhythmic effects, normalization of heart rate variability, reduction of myocardial ischemia, reduction in sudden cardiac death cases.
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