ИСПОЛЬЗОВАНИЕ АНАЛИЗА QRS ДЛЯ ОПРЕДЕЛЕНИЯ РИСКА ЖЕЛУДОЧКОВЫХ АРИТМИЙ У ПАЦИЕНТОВ С ИШЕМИЧЕСКОЙ БОЛЕЗНЬЮ СЕРДЦА И ИМПЛАНТИРОВАННЫМИ КАРДИОВЕРТЕРАМИ-ДЕФИБРИЛЛЯТОРАМИ

To assess correlation between the portion (percentage) of the scar tissue in the left ventricle (LV) and the risk of ventricular arrhythmias in patients with coronary artery disease and implanted cardioverter-defibrillator (ICD), 49 patients (46 men and 3 women) aged 63±12 years were examined. Only patients with ischemic cardiomyopathy were included into the study (LV ejection fraction less than 45%). Prior to the ICD implantation, 48 patients underwent aorto-coronary bypass grafting or percutaneous coronary intervention. In all patients, prior to the ICD implantation performed were echocardiography and ECG analysis using the computational tables (method by R.H. Selvester et al. for assessment of the scar tissue area). The patients were distributed into two following groups: Group I included patients without the ICD activity (n=25) and Group II, patients with the episodes of ICD activation (n=24). The percentage of scar tissue was 17.3±8.8 ΰ /ο in Group I and 25.5±13.4 ΰ /ο in Group II (p=0.014). The QRS complex width did not statistically significantly differ in both groups (127.6±35.6 ms in Group I and 121.9±34.6 ms in Group II; p=0.58). It could be related to fact that the QRS widening in the patients with ischemic cardiomyopathy can be considered a predictor of death due to heart failure deterioration. A statistically significantly lower LV ejection fraction in the patients without episodes of ICD activity (Group I) is possible related to a greater number of patients with ICDs implanted for the primary sudden death prevention. Principal limitations of the current study were a small sample and the retrospective nature of the study. Thus, ECG assessment using the technique by R.H. Selvester et al. can be used for the risk stratification of ICD activity due to ventricular arrhythmias.