Cardiac hemodynamics and myocardial contractility in patients with ventricular arrhythmias

Objective: To evaluate cardiac function before and after radiofrequency ablation in patients with ventricular arrhythmias. Material and methods: The study included patients (n=22, mean age of 43 5±11.7 years) with ventricular arrhythmias (VA): premature ventricular beats (n=17) and paroxysmal ventricular tachycardia (n=5). Procedure of radiofrequency ablation (RFA) of ventricular arrhythmia was performed in 22 patients according to appropriate indications. Comparison group comprised 15 patients (mean age of 56.3±8.3 years) without cardiac arrhythmias. All patients underwent a complete clinical examination including gated blood pool SPECT (GBP-SPECT). Results. Compared with control group, patients with ventricular arrhythmia had moderate dilatation and reduced contractile function of both ventricles. The value of RV EF in patients with VA were significantly lower than in the control group (43.25±8.08% and 54.35±12.48%, p<0.05, respectively). The intra- and interventricular dyssynchrony was significantly higher in patients with VA and was most pronounced in the right ventricle. Interventricular dyssynchrony value was normal (<50 ms). After RFA procedure, the value of intraventricular dyssynchrony of right ventricle significantly decreased. In addition, left ventricular EDV and EF, as well as right ventricular EsV and ESI significantly decreased. The values of contractility indices of the right ventricle significantly increased. Conclusion. Ventricular arrhythmia had a negative impact on myocardial contractility, which normalized after the removal of the pathological ectopic focus. The degree of hemodynamic disturbances was determined not only by the fact of ectopia, but also by its localization.

желудочковые аритмии, радионуклидная томовентрикулография, радиочастотная аблация, ventricular arrhythmia, gated blood pool SPECT, radiofrequency ablation

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