MYOCARDIAL ECTOPIC ACTIVITY IN PATIENTS WITH DIFFERENT CLINICAL FORMS OF PULMONARY TB

Abstract

TB infection is often accompanied by changes in electrophysiological properties of the myocardium, which may result in rhythm and conduction disturbances; the administration of cardiotoxic TB drugs requires control of their safety for patients. 

Aim. To evaluate the structure and frequency of heterotopic rhythm disturbances in patients with different forms of pulmonary TB. 

Materials and methods. We studied 116 pulmonary TB patients without heart disease – 57 men and 59 women aged 18-78 years; the average age was 45.8 ± 14.77 years. All underwent 24-hour ECG monitoring. The monitograms were analyzed using the 24-hour ECG. The results were processed using MS EXCEL 2016 for Windows. 

Results. The average heart rate (HR) throughout the day, average HR in the afternoon, and average nighttime HR did not differ from those in general population. Heart rhythm disturbances were detected in 94.83% of cases (110 patients). Supraventricular extrasystoles prevailed over other rhythm disorders. Among ventricular extrasystoles the most common were rare monomorphic ventricular extrasystoles, class 1 according to the classification of B. Lown, M. Wolf, and M. Ryan. Combined supraventricular and ventricular rhythm disorders were detected in 21.6% of cases (25 patients). Prognostically unfavourable rhythm disorders were detected in 45.6% of cases (25 patients). Rhythm disorders were more common in middle-aged or older male patients with pulmonary TB (р˃0.05).

Conclusion. Practically all types of heart rhythm disturbances were diagnosed in pulmonary TB patients, including co-existing several types of arrhythmias. Prognostically unfavourable disorders were detected in 45.6% of cases. Pulmonary TB patients need regular control of heart rhythm and timely correction of disorders; 24-hour ECG monitoring is strongly advised since rhythm disorders may be unexpressed and not detected at rest.