Arrhythmia Burden in Heart Failure Patients in a Referral Centre in Southern Nigeria
##plugins.themes.bootstrap3.article.sidebar##
##plugins.themes.bootstrap3.article.main##
Resumo
Background: Heart failure is the ultimate effect of
all cardiovascular disorders with a rapid increase in
its prevalence. The risk of sudden death is high in
heart failure and has been attributed to progressive
pump failure and arrhythmias especially ventricular
arrhythmia.
Objectives: This study aims to determine the
arrhythmia burden in heart failure patients
Methodology: Ninety adults with heart failure were
assessed. A 24-hr Holter Electrocardiographic
monitoring was done using a 12 - channel Edan®
Holter recorder, trans-thoracic echocardiography and
rest ECG was performed on all subjects. Continuous
variables were compared by the student’s t- test while
categorical parameters were compared with the chi
square test or two tailed Fisher’s exact test as
appropriate. Pearson’s correlation coefficient was
used to assess the relationship between
echocardiographic parameters against the number of
arrhythmia/hours on Holter ECG.
Results: The mean age of the subjects was
49.8±14.4years with a female preponderance of
1.4:1. Arrhythmias such as isolated ventricular ectopic
(100%), isolated atrial ectopics (91.1%) non
sustained ventricular tachycardia (16.7%) and atrial
fibrillation (20%) were noted on Holter ECG. There
was a significant positive correlation between the left
ventricular internal wall diameters in diastole (LVIDd)
and the number of VE/hour (p = <0.001) with a
negative correlation between the ejection fraction and
the number of VE/hour (p = 0.023).
Conclusion: The frequency of arrhythmias is high
in heart failure patients. Left ventricular systolic
dysfunction and chamber size were major
determinants of arrhythmias and could be used in
identifying high-risk patients in a bid to initiate
preventive measures if necessary.
##plugins.themes.bootstrap3.article.details##
Secção
Referências
Ziaeian B, Fonarow GC. Epidemiology and
aetiology of heart failure. Nat Rev Cardiol
[Internet]. 2016 3;13(6):368–78.
Mosterd A, Hoes AW. Clinical epidemiology of
heart failure. Heart . 2007 ;93(9):1137–46.
Nwafor CE, Alikor CA. Pattern of
cardiovascular disease admissions in the medical
wards of university of Portharcourt Teaching
Hospital. Niger Heal J. 2016;16 (2)
Ojji DB, Alfa J, Ajayi SO, Mamven M, Falase
AO. Pattern of heart failure in Abuja , Nigeria:
an echocardiographic study. Cardiovasc J Afr.
;20(6):349–52.
Levy WC, Mozaffarian D, Linker DT, Sutradhar
SC, Anker SD, Cropp AB, et al. The Seattle Heart
Failure Model. Circulation . 2006 Mar
;113(11):1424–33.
Ajayi O, Abiodun O, Akintomide A, Adebayo R,
Ogunyemi S, Balogun M, et al. Pattern of
arrhythmias among Nigerians with congestive
heart failure. Int J Gen Med [Internet].
;8:125.
Masarone D, Limongelli G, Rubino M, Valente F,
Vastarella R, Ammendola E, et al. Management
of Arrhythmias in Heart Failure. J Cardiovasc
Dev Dis 2017, Vol 4, Page 3 . 2017 ;4(1):3.
Santangeli P, Rame JE, Birati EY, Marchlinski
FE. Management of Ventricular Arrhythmias
in Patients With Advanced Heart Failure. J Am
Coll Cardiol. 2017 11;69(14):1842–60.
Saltzman HE. Arrhythmias and Heart Failure.
Cardiol Clin. 2014 Feb;32(1):125–33.
Masarone D, Limongelli G, Rubino M, Valente F,
Vastarella R, Ammendola E, et al. Management
of Arrhythmias in Heart Failure. J Cardiovasc
Dev Dis . 2017 2019;4(1):3.
Lan SC, Czer L, Wolf PL, Denton TA, Shintaku
IP, Chen P-S, et al. Relationship Between
Regional Cardiac Hyperinnervation and
Ventricular Arrhythmia. Circulation. 2000
;101:1960–9.
Hoss S, Elizur Y, Luria D, Keren A, Lotan C,
Gotsman I. Accepted Manuscript Serum
Potassium Levels and Outcome in Patients with
Chronic Heart Failure. Am J Cardiol. 2016;
Heist EK, Ruskin JN. Contemporary Reviews
in Cardiovascular Medicine Drug-Induced
Arrhythmia. Circulation.2010; 122:1426-1435.
Hunt SA, Abraham WT, Chin MH, Feldman AM,
Francis GS, Ganiats TG, et al. 2009 Focused
Update Incorporated Into the ACC/AHA 2005
Guidelines for the Diagnosis and Management
of Heart Failure in Adults. J Am Coll Cardiol .
;53(15):e1–90.
Crawford MH, Bernstein SJ, Deedwania PC,
DiMarco JP, Ferrick KJ, Garson A, et al. ACC/
AHA Guidelines for Ambulatory
Electrocardiography: Executive Summary and
Recommendations. Circulation. 1999
;100(8):886–93.
Lang RM, Badano LP, Mor-Avi V, Afilalo J,
Armstrong A, Ernande L, et al.
Recommendations for Cardiac Chamber
Quantification by Echocardiography in Adults: An
Update from the American Society of
Echocardiography and the European Association
of Cardiovascular Imaging. J Am Soc
Echocardiogr. 2015 Jan;28(1):1-39.e14.
Devereux RB. Detection of left ventricular
hypertrophy by M-mode echocardiography.
Anatomic validation, standardization, and
comparison to other methods. Hypertension . 1987
;9(2_pt_2).
Nagueh SF, Smiseth OA, Appleton CP, Byrd BF,
Dokainish H, Edvardsen T, et al.
Recommendations for the Evaluation of Left
Ventricular Diastolic Function by
Echocardiography: An Update from the
American Society of Echocardiography and the
European Association of Cardiovascular Imaging.
Eur Hear J – Cardiovasc Imaging.
;17(12):1321–60.
Damasceno A, Mayosi BM, Sani M, Ogah OS,
Mondo C, Ojji D, et al. The Causes, Treatment,
and Outcome of Acute Heart Failure in 1006
Africans From 9 Countries. Arch Intern Med .
:;172(18):1386.
Yancy CW, Abraham WT, Albert NM, Clare R,
Stough WG, Gheorghiade M, et al. Quality of
Care of and Outcomes for African Americans
Hospitalized With Heart Failure. J Am Coll
Cardiol. 2008 Apr;51(17):1675–84.
Nieminen MS, Brutsaert D, Dickstein K, Drexler
H, Follath F, Harjola V-P, et al. EuroHeart Failure
Survey II (EHFS II): a survey on hospitalized
acute heart failure patients: description of
population. Eur Heart J . 2006;27(22):2725–36.
Abraham WT, Fonarow GC, Albert NM, Stough
WG, Gheorghiade M, Greenberg BH, et al.
Predictors of In-Hospital Mortality in Patients
Hospitalized for Heart Failure. J Am Coll Cardiol
[Internet]. 2008;52(5):347–56.
Ogah OS, Stewart S, Falase AO, Akinyemi JO,
Adegbite GD, Alabi AA, et al. Contemporary
Profile of Acute Heart Failure in Southern
AO Ajala, S Dodiyi-Manuel, B Oyan and MR Akpa
Nigeria: Data From the Abeokuta Heart Failure
Clinical Registry. (“Contemporary profile of acute
heart failure in Southern Nigeria: Data ...”) JACC
Hear Fail. 2014;2(3):250–9.
Lasisi GT, Adebola AP, Ogah OS, Daniel FA.
Prevalence of ventricular arrhythmias and heart
rate variability pattern in chronic heart failure.
Niger Postgrad Med J. 2012 Sep;19(3):157–62.
National bureau statistics. South-south leads
Nigeria’s huge alcohol consumption, NBS data
shows. Alcohol Consum Niger. 2016; Available
from: https://www.premiumtimesng.com/health/
health-features/334887-south-south-leadsnigerias-huge-alcohol-consumption-nbs-datashows.htm
Sarwar M, Muhammad S, Majeed I, Khan MA,
Ahmed T, Shabbir F. Effect of Age and Gender
on Arrhythmias in Patients With Chronic Heart
Failure. Pak J Physiol. 2013;99(22):11–4.
Ehrlich JR, Nattel S, Hohnloser SH. Atrial
fibrillation and congestive heart failure: Specific
considerations at the intersection of two common
and important cardiac disease sets. Journal of
Cardiovascular Electrophysiology. 2002.
Wang TJ, Larson MG, Levy D, Vasan RS, Leip
EP, Wolf PA, et al. Temporal Relations of Atrial
Fibrillation and Congestive Heart Failure and
Their Joint Influence on Mortality. Circulation.
;107(23):2920–5.
Cygankiewicz I, Zareba W, de Luna AB.
Prognostic value of Holter monitoring in
congestive heart failure. Cardiology Journal.
Adebayo R, Ikwu A, Balogun M, Akintomide A,
Ajayi O, Adeyeye V, et al. Heart rate variability
and arrhythmic patterns of 24-hour Holter
electrocardiography among Nigerians with
cardiovascular diseases. Vasc Health Risk
Manag. 2015;11:353–9.
Tsang TSM, Barnes ME, Gersh BJ, Bailey KR,
Seward JB. Left atrial volume as a
morphophysiologic expression of left ventricular
diastolic dysfunction and relation to
cardiovascular risk burden. Am J Cardiol.
;90(12):1284–9.
Simpson RJ, Cascio WE, Schreiner PJ, Crow
RS, Rautaharju PM, Heiss G. Prevalence of
premature ventricular contractions in a population
of African American and white men and women:
The Atherosclerosis Risk in Communities
(ARIC) study. Am Heart J . 2002;143(3):535–
Akdemir B, Yarmohammadi H, Alraies MC,
Adkisson WO. Premature ventricular
contractions: Reassure or refer? Cleve Clin J
Med. 2016 ;83(7):524–30.