The Ventricular arrhythmias in patients with congestive heart failure:A case series from the Democratic Republic of Congo
Mots-clés :
Premature Ventricular Contractions, Nonsustained ventricular tachycardia - LubumbashiRésumé
Background
Ventricular arrhythmias result in high heart failure mortality. They should be routinely sought, diagnosed, and treated effectively.
Methods
Twenty-four Holter ECG were recorded in 43 patients with either dilated cardiomyopathy, peripartum cardiomyopathy or hypertensive cardiomyopathy, who presented congestive heart failure, both at University Teaching Clinics and Lubumbashi's Centre of Cardiology from November 2017 through January 2019.
They all had premature ventricular contractions (PVCs). Nevertheless, 53% of them had numerous-to-very numerous PVCs (>40/hr) with a mean for 24-hr equal to 8633 (range= 30409), predicted by age (OR=1.094, 95% CI: 1.031-1.182), systolic blood pressure (OR=0.9 CI 0.92-0.995) and to some extent magnesium levels (OR=0.111 95% CI: 0.006-1.044).
Almost half (49%) of them had nonsustained ventricular tachycardia which was predicted by numerous-to-very numerous PVCs (OR=8.8, 95% CI: 1.2-88), triplets (OR=32, 95% CI: 5-387) as well as hemoglobin levels (OR= 1.7, 95% CI: 1-3.3).
Conclusion
Ventricular arrhythmias are very common in congestive heart failure's patients of Lubumbashi. Given the risk of sudden death in these patients, adequate monitoring and management, including decongesting patients and correcting hemodynamic and electrolytic disorders, should be instituted promptly and guideline-directed medical therapies commenced.
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Références
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