Disturbances of a Rhythm and Conduction in Patients with a Chronic Pulmonary Heart and Their Correction with a Nebilet Preparation
The cardiac rhythm disturbances frequently attend a chronic pulmonary heart (ChPH) development. An insufficient effectiveness of a traditional antiarrhythmic therapy in patients with the chronic obstructive diseases of lungs necessitates a search of the new methods of treatment.
The aim of investigation is a study of the cardiac rhythm and conduction disturbance character and rate in patients with a ChPH depending on a clinicofunctional class (CFC), detection of the nebilet (nebivolol) superselective beta-blocker use effectiveness in patients with extrasystole and ciliary arrhythmia.
Materials and Methods. 125 humans with a ChPH (average age is 57,3±0,89 years) are examined. All the patients were divided into two basic groups: the 1st one — with a pulmonary heart without an attendant ischemic heart disease (IHD) and the 2nd one — with a combination of a pulmonary heart and IHD. According to a ChPH flow the patients were divided into four CFC. The patients were undergoing a physical examination, a general analysis of blood investigation, investigation of the external respiration function (ERF), electrocardiography (ECG), a daily monitoring of ECG according to Holter, echocardiography (echoCG) with a systolic pressure registration in a pulmonary artery, detection of acidic and basic state of blood.
An ″acute″ experiment (n=25) and a course treatment with a nebilet preparation in patients with a ChPH (n=17) were conducted.
Results and discussion. The alterations of the ERF values, echoCG and acidic and basic state of blood depending on a CFC were compared. The rhythm and conduction disturbances in patients of the 1st group at the Holter’s monitoring were 95%. The supraventricular rhythm disturbances were diagnosed in 92.5%, the ventricular ones — in 65% of patients; a combination of the several types of arrhythmias and blockades was frequently registered. A tendency to the ventricular rhythm disturbance increase, an increase of the high gradation ventricular extrasystole per cent was observed in patients with attendant IHD (2nd group). A more significant intercommunication between the pathogenetic factors and their influence on arrhythmia development with a use of a correlation analysis with the Spierman’s coefficient detection are determined.
An ‘acute’ medicinal experiment and a course treatment with nebilet were conducted. An effectiveness of the nebilet beta-adrenoblocker use at the extrasystole treatment without aggravation of the peak expiration rate is marked. A transition of the auricle fibrillation tachysystolic form to a normosystolic one is registered in several patients.
