Pro-arrhythmogenic factors in patients with acute decompensated chronic heart failure

The search of pro-arrhythmogenic factors in patients with acute decompensated chronic heart failure (ADCHF) is relevant. Various abnormalities in myocardial repolarization and QTc prolongation are associated with the risk of ventricular arrhythmia. Previous studies have shown that increased temporal variability of repolarization, reflected by QT interval variability, can predict spontaneous ventricular arrhythmias. QT variability index is a non-invasive sudden cardiac death marker. The objective of the research was to evaluate QT interval, heart rate variability and turbulence, the number of ventricular extrasystoles and to define the influence of acute renal injury in patients hospitalized with acute decompensated chronic heart failure. Materials and Methods. Twenty-four-hour Holter recordings from 103 patients with аcute decompensated chronic heart failure were double analyzed during hospitalization using automatic algorithm to measure QT and heart rate to analyze the pro-arrhythmogenic factors. Results. It was established that аcute decompensated chronic heart failure was accompanied by QT and QTc prolongation. Stabilization was characterized by normalization of QT interval in most patients. QTc prolongation up to more than 440 ms under acute decompensated chronic heart failure was observed in 42 (41 %) patients. Acute kidney injury affected QT prolongation in males. Such an effect maintained until hospital discharge. Women did not demonstrate the influence of acute kidney injury effect on QT prolongation. On the 10th day of treatment, the same number of ventricular extrasystoles per day was observed. Patients with sinus rhythm revealed increased QT variability index, pathological values of heart rate turbulence, i.e. the beginning of the turbulence and its versions. Indicators of heart rate variability, which exceeded cut-off values of mortality risk, did not improve under clinical stabilization. Conclusion. In spite of clinical stabilization patients with acute decompensated chronic heart failure still demonstrate arrhythmogenic factors.