Multi-day telemonitoring is the optimum control method in the medicational treatment of arrhythmias

T. É. Tulintseva, V. Tikhonenko, E. Zhabina, T. Treshkur
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Abstract

Background. The use of antiarrhythmic (AA) drugs requires constant monitoring due to the risk of arrhythmic and side effects. It is impossible to quickly identify and respond to emerging adverse events using 24-hour monitoring of the electrocardiogram (ECG), due to the method technical features. The introduction into practice of multi-day telemonitoring (MTM) of ECG contributes to an increase in the detection of rare and asymptomatic arrhythmias, and improves control over the AA therapy effectiveness.Objective. To study the possibilities and advantages of MTM in the selection of AA therapy and the prevention of its complications in patients with ventricular arrhythmias (VA).Design and methods. The study included 73 patients with frequent symptomatic high-grade VA (44 women and 29 men) aged 28 to 86 years (56.6 ± 28.3 years), in whom MTM ECG was performed for the purpose of individual selection of AA therapy.Results. In 19 % patients using MTM, the psychogenic nature of VA and a necessity to avoid prescribing was suspected. In 63 % patients with VA the optimal AA therapy in the minimum effective doses was selected using MTM, in 18 % patients the futility of drug therapy was proven and radiofrequency ablation was recommended.Conclusion. MTM ECG is justified for the selecting AA therapy in patients with VA. MTM has undoubted advantages over daily monitoring and helps to reduce the time for AA agent choosing.
多日远程监护是心律失常药物治疗的最佳控制方法
背景。由于心律失常和副作用的风险,使用抗心律失常(AA)药物需要持续监测。由于该方法的技术特点,使用24小时心电图(ECG)监测不可能快速识别和应对新出现的不良事件。心电多天远程监护(MTM)的应用有助于提高对罕见和无症状心律失常的检出率,提高对心电治疗效果的控制。探讨MTM在室性心律失常(VA)患者AA治疗方案选择及并发症预防中的可能性和优势。设计和方法。本研究纳入73例频繁出现症状的高级别VA患者(女性44例,男性29例),年龄28 ~ 86岁(56.6±28.3岁),行MTM心电图检查,以确定AA治疗方案的个体化选择。在19%使用MTM的患者中,怀疑VA的心因性和避免处方的必要性。在63%的VA患者中,采用MTM选择最小有效剂量的最佳AA治疗,18%的患者证实药物治疗无效,建议射频消融。MTM心电图是VA患者选择AA治疗的合理依据,与日常监测相比,MTM具有无可置疑的优势,有助于减少AA药物的选择时间。
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