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№1' 2015

CARDIOLOGY

International Medical Journal, Vol. 21., Iss. 1, 2015, P. 12−17.


THE ROLE OF HOLTER ECG MONITORING IN STRATIFICATION OF RISK FOR SUDDEN CARDIAC DEATH IN PATIENTS AFTER MYOCARDIAL INFARCTION


Dushina Ye. V., Lukianov M. V., Oleynikov V. E.

Penza State University, Medical Institute, Russian Federation

The review analyzes the recent literature data on evaluation of prognostic value of the parameters obtained by Holter ECG monitoring in stratification of the risk of sudden cardiac death in patients after myocardial infarction. The urgency of the problem is due not only to its prevalence, but also an opportunity for preventive interventions. According to Holter monitoring, in 85 % of cases the mechanisms of sudden cardiac death are ventricular tachycardia and ventricular fibrillation, other causes are bradyarrhythmia and asystole. Predictive value of LVP (late ventricular potentials) used for detection of high−resolution ECG monitoring is discussed. It is noted that despite the numerous studies on QT dispersion in patients with acute myocardial infarction, its predictive value has to be confirmed. The method of T−wave alternation is important for prediction of sudden cardiac death. A promising method in solving this problem is investigation of variability of heart rate and turbulence. The authors conclude about the need for further randomized studies to prove the predictive value of individual markers for risk stratification of sudden cardiac death.

Key words: Holter ECG monitoring, sudden cardiac death, heart rate variability, late ventricular potentials, QT dispersion, heart rate turbulence, micro−wave alternations of T−wave.


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