D. Mroczek-Czernecka

Analysis of Circadian Distribution of Premature Ventricular Contractions in Patients After Heart Transplantation

The aim of our study was to analyze circadian distribution of premature ventricular contractions (PVC) and its coupling interval (CI) in patients after orthotopic heart transplantation (HTx). Forty‐two patients (5 females, 37 males) were monitored from 2 weeks to 5 years after HTx; 180 24‐hour Holter ECG studies were performed. All recordings were divided into two groups: group I, within 1 month after HTX; and group II, after 1 month. Patients with more than 250 PVC/24 hours were selected for distribution of PVC and CI evaluation. Conclusions: Ventricular arrhythmias occur frequently in patients after heart transplantation. In patients with high Lown scale arrhythmias low occurrence (< 250/24 hours) of PVC was frequently observed (IVa: 81.8%; IVb: 84.7%). Similar patterns of circadian distribution (CD) of PVC and CD of HR in denervated heart after HTx suggest the influence of circulating catecholamines on their occurrence.

3. Vasovagal Syncope, Tilt Testing

The aim of study was to evaluate a psychological profile (PSP) of patients with diagnosed vaso-vagal syncope (VVS). We observed 30 pts. (12 men and 18 women), aged 19-61 yrs, with history of neurocardiogenic syncope (NS) and positive head-up tilt test (HUTT) acc. to Westminster protocol. All patients, before HUTT, underwent psychological evaluation with the packet of the following tests: Based on results of mentioned tests psychological profile of each patient was performed. Results Vaso-depressive VVS was diagnosed in 17 pts, cardio-inhibitory VVS – 1 pt and mixed VVS 12 pts. There were achieved the following mean results of performed psychological tests: Conclusions Psychological characteristics of patients with vaso-vagal syncope is characterised by:-a reduction in the health related quality of life, -a slight increase in anxiety level and an increase in inner tension, -a slight increase in anxiety level is a result of an increase in inner tension which itself is a result of an inner conflict between urges and a restrictive superego.

P.3. Basic Science, Sudden Death Risk Stratification and Ventricular ArrhythmiasP.3.29 The Influence of Beta-Blockade on Sudden Cardiac Death Risk in Patients with Heart Failure

Aim To assess the influence of 12-month carvedilol therapy on sudden cardiac death (SCD) risk in patients (pts) with heart failure (HF). Material 86 pts (81males) in the age of 35-70 years with chronic, symptomatic HF, treated at least for 3 month by ACE-I and diuretics, not treated by beta-blockers. CHF was in 66 pts of ischemic origin and in 20 pts – idiopathic. 30 pts (35%) were in II NYHA class and 56 pts (65%) – in III. Methods In all study pts the presence of SCD risk factors was assessed basically and after 12 month carvedilol therapy. The SCD risk factors, studied in this paper, were: left ventricle ejection fraction (LVEF) below 30%, left ventricular end diastolic volume (LVEDV) over 140 ml in echo assessment, the presence of complex ventricular arrhythmias, pathologic values of turbulence parameters (TO and TS) and heart rate variability (SDNN below 100 ms) in ECG Holter monitoring, the presence of late potentials and wide QRS complexes over 114 ms in signal averaged ECG, heart rate at rest (hrs) over 75/min, persistent atrial fibrillation (AF) and prolonged qtc interval over 440 ms in rest ECG. Results During 12-month therapy and 36 ± 8 month follow-up 5 pts died and 2 pts had heart transplantation. From 10 analyzed SCD risk factors the significant changes were found in 3. They are listed in the table below: ![Graphic][1] The average number of SCD risk factors was 5 per pt basically and decreased significantly to 4 (p=0.001) after 12-month carvedilol therapy. Conclusion The continuous beta adrenergic blockade decreases the SCD risk by decreasing the prevalence of SCD risk factors. [1]: /embed/graphic-1.gif

The Influence of Beta-Blockade on Sudden Cardiac Death Risk in Patients With Heart Failure

Aim To assess the influence of 12-month carvedilol therapy on sudden cardiac death (SCD) risk in patients (pts) with heart failure (HF). Material 86 pts (81males) in the age of 35-70 years with chronic, symptomatic HF, treated at least for 3 month by ACE-I and diuretics, not treated by beta-blockers. CHF was in 66 pts of ischemic origin and in 20 pts – idiopathic. 30 pts (35%) were in II NYHA class and 56 pts (65%) – in III. Methods In all study pts the presence of SCD risk factors was assessed basically and after 12 month carvedilol therapy. The SCD risk factors, studied in this paper, were: left ventricle ejection fraction (LVEF) below 30%, left ventricular end diastolic volume (LVEDV) over 140 ml in echo assessment, the presence of complex ventricular arrhythmias, pathologic values of turbulence parameters (TO and TS) and heart rate variability (SDNN below 100 ms) in ECG Holter monitoring, the presence of late potentials and wide QRS complexes over 114 ms in signal averaged ECG, heart rate at rest (hrs) over 75/min, persistent atrial fibrillation (AF) and prolonged qtc interval over 440 ms in rest ECG. Results During 12-month therapy and 36 ± 8 month follow-up 5 pts died and 2 pts had heart transplantation. From 10 analyzed SCD risk factors the significant changes were found in 3. They are listed in the table below: ![Graphic][1] The average number of SCD risk factors was 5 per pt basically and decreased significantly to 4 (p=0.001) after 12-month carvedilol therapy. Conclusion The continuous beta adrenergic blockade decreases the SCD risk by decreasing the prevalence of SCD risk factors. [1]: /embed/graphic-1.gif

P.3. Basic Science, Sudden Death Risk Stratification and Ventricular Arrhythmias

Aim To assess the influence of 12-month carvedilol therapy on sudden cardiac death (SCD) risk in patients (pts) with heart failure (HF). Material 86 pts (81males) in the age of 35-70 years with chronic, symptomatic HF, treated at least for 3 month by ACE-I and diuretics, not treated by beta-blockers. CHF was in 66 pts of ischemic origin and in 20 pts – idiopathic. 30 pts (35%) were in II NYHA class and 56 pts (65%) – in III. Methods In all study pts the presence of SCD risk factors was assessed basically and after 12 month carvedilol therapy. The SCD risk factors, studied in this paper, were: left ventricle ejection fraction (LVEF) below 30%, left ventricular end diastolic volume (LVEDV) over 140 ml in echo assessment, the presence of complex ventricular arrhythmias, pathologic values of turbulence parameters (TO and TS) and heart rate variability (SDNN below 100 ms) in ECG Holter monitoring, the presence of late potentials and wide QRS complexes over 114 ms in signal averaged ECG, heart rate at rest (hrs) over 75/min, persistent atrial fibrillation (AF) and prolonged qtc interval over 440 ms in rest ECG. Results During 12-month therapy and 36 ± 8 month follow-up 5 pts died and 2 pts had heart transplantation. From 10 analyzed SCD risk factors the significant changes were found in 3. They are listed in the table below: ![Graphic][1] The average number of SCD risk factors was 5 per pt basically and decreased significantly to 4 (p=0.001) after 12-month carvedilol therapy. Conclusion The continuous beta adrenergic blockade decreases the SCD risk by decreasing the prevalence of SCD risk factors. [1]: /embed/graphic-1.gif