Abstract
Introduction.
According to different authors various arrhythmias at an early postoperative stage in patients
with coronary artery disease, are found in 20-40%. It is well known that patients with metabolic syndrome
tend to have multivessel desease. The challenge of this study was to determine the prognostic criteria for the
occurrence of cardiac arrhythmias in surgical patients with coronary artery disease with and without
metabolic syndrome.
Material and methods.
The study involved 114 patients with coronary artery disease hospitalized for surgical
treatment, all patients were divided into 2 groups: 1 group consisted of 77 patients with coronary heart di
sease and metabolic syndrome (MS), 2 group - 37 patients without MS. Considered groups of patients were
matched by duration of coronary heart disease, by effort angina FC III-IV.
Results.
Of arrhythmias of patients in groups 1 and 2 was detected frequent supraventricular arrhythmias -
with 42 (54.6%) and 6 (16.2%), respectively (p = 0.001) paroxysmal supraventricular tachycardia - with 30
(38.9%) and 12 (32.4%) patients, respectively (p=0.9). Atrial fibrillation was observed with in 34 (44.2%) of
Group 1 and 3 (8.1%) in Group 2 (p=0.001). Ventricular premature beats low grades on Lown-Wolf - in 19
(24.7%) and 9 (24.3%) patients, respectively. Ventricular premature beats 4a grading Lown-Wolf - in 16
(20.7%) and 3 (8.1%) patients, respectively (p=0.08), 4B grading Lown-Wolf - 16 (20.7%) patients with MS
and in the presence of 5 (13.5%) of subjects without MS (p=0.4).
In the early postsurgery paroxysmal atrial fibrillation were observed in 62 (80.6%) of Group 1 and 5 (13.5%)
of Group 2 (p=0.001). Ventricular premature beats low grades on Lown-Wolf - in 18 (23.4%) and 9 (24.3%)
patients, respectively, ventricular extrasystoles 4A grading Lown-Wolf - 35 (45.5%) of Group 1 and 3 (8.1%)
of Group 2 (p=0.001). 4B grading Lown-Wolf - 17 (22.1%) patients of Group 1, and 5 (13.5%) patients of
Group 2 (
p
=0.27).
Conclusions.
The presence of the MS is one of the major risk factors for cardiac arrhythmias of patients with
coronary heart disease after bypass surgery. The main risk factors for supraventricular arrhythmias in patients
with MS, coronary artery disease are: age, changes in heart rate variability, the presence of hypertension. The
presence of the MS in patients, an increase in left ventricular ejection fraction decrease in total are predic
tors of ventricular arrhythmias in patients with coronary artery disease. With increasing age and functional
class of angina, decreased heart rate variability and registration of ventricular late potentials increases the
probability of their occurrence.
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