Why the study?
The study was conducted to compare the presence, frequency, and duration of myocardial ischemia episodes and arrhythmias on Holter monitoring in patients with CHD depending on the condition of the coronary arteries.
Do patients with INOCA have different frequencies and durations of myocardial ischemia and arrhythmias on Holter monitoring compared to patients with obstructive coronary artery disease?
Do patients with INOCA have different frequencies and durations of myocardial ischemia and arrhythmias on Holter monitoring compared to patients with obstructive coronary artery disease?
Patients with INOCA may experience longer durations of myocardial ischemia on Holter monitoring compared to those with obstructive CAD, although severe ventricular arrhythmias are more common in obstructive disease.
Answers are grounded in this paper and cite their sources.
Longer ischemia duration in INOCA on Holter warrants vigilance; leaves open whether findings alter risk stratification versus obstructive CAD.
The aim – to conduct a comparative analysis of the presence, frequency and duration of episodes of myocardial ischemia and arrhythmias based on the results of Holter monitoring in patients with coronary heart disease depending on the condition of the coronary arteries. Materials and methods. We examined 53 patients (group I) with stable coronary heart disease (CHD) and slightly altered coronary arteries (INOCA), who were hospitalized in the period from October 2018 to February 2021 at the “City Clinical Hospital № 8” of Kharkiv City Council. Group II included 52 patients with a diagnosis of stable coronary heart disease, and according to coronary angiography (CAG) had stenosis of coronary arteries (CA) more than 50 %. Results. According to the results of comparative analysis, it was found that in group I there were signs of myocardial ischemia – depression of the ST segment in 62.3 % (n=33) and elevation of the ST segment in 11.3 % (n=6), compared with group II -73 % (n=38) and 5.66 % (n=3), respectively. Ventricular arrhythmias (VA) have been reported in 52 patients of group I, and in 44 patients of group II. VA 4 and 5 type according to Laun, was significantly higher in group II compared with group I (p=0.0324). The occurrence of ventricular tachycardia was recorded in 5.7 % (n=3) of patients in group I and 9.3 % (n=5) patients of group II (p=0.347). In group II, there was a tendency to more episodes of ischemia compared with group I (p=0.072). The duration of ischemia was significantly longer in group I, compared with group II (p=0.042). Conclusions. The results of the study did not show significant differences in the development of the number of episodes of myocardial ischemia according to Holter monitoring depending on the condition of the coronary arteries. The duration of episodes of ischemia in patients with INOCA is significantly longer than in patients with obstructive atherosclerosis. In patients with coronary heart disease with obstructive coronary arteries, ventricular arrhythmia was statistically significantly more severe according to Lown
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Tetiana Pylova (2021) studied this question.
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