Risk of life-threatening arrhythmias in smoking patients

• Main Authors: A. I. Vytryhovskiy, S. V. Fedorov, N. M. Kylaec
• Format: Article
• Language: English
• Published: Zaporozhye State Medical University 2017-06-01
• Series: Zaporožskij Medicinskij Žurnal
• Subjects: cardio-vascular risk; ventricular extrasystole; heart rate determination
• Online Access: http://zmj.zsmu.edu.ua/article/view/100591/97152
• ISSN: 2306-4145; 2310-1210

Despite the prophylactic medicine achievements through the past decade, tobacco smoking remains one of the main risk factors of appearance and progression of diseases, which are accompanied by the high population mortality. Aim: development of the new approaches of complications prediction, prophylaxis and treatment in patients with high and very high total cardiovascular risk, which are based on the heart rhythm turbulence evaluation. Materials and Methods: 603 patients were chosen for the research. All patients were divided into tree groups. The first – patients with IHD without concomitant risk factors, such as smoking, obesity, metabolic syndrome. The second – patients, who smoke for more than 2 years (people with very high cardiovascular risk by SCORE scale). The third group – patients with metabolic syndrome without IHD or hypertension (patients with high cardiovascular risk). Control group included 149 patients. Holter monitoring of the heart rhythm was performed in patients with high and very high cardiovascular risk by the SCORE scale with myocardial infarction to study the specifications of the heart rhythm turbulence. Plasma calcium and magnesium levels were measured to establish the correlation between appearance and progression of ventricular arrhythmia and increase of the heart rhythm turbulence phenomenon. Results. The prevalence of ventricular and supraventricular arrhythmia is reliably higher among the smokers than among healthy persons. The highest percentage of the ventricular extrasystoles both the early appearing extrasystoles and the group extrasystoles is observed among smokers. Among healthy people every fourth person has deviations in heart rhythm turbulence indices, and every seventeenth has significant deviations and high risk of cardiac sudden death. Smokers have reliable decrease of calcium and increase of magnesium plasma levels. People with heart rhythm turbulence, metabolic syndrome and hypertension have reliable increased in calcium plasma concentration compared with people with metabolic syndrome but without hypertension. Conclusions. 1) Smoking contributes to increase the polytopic extrasystoles prevalence. 2) Smokers have higher acceleration and deceleration levels of the heart rhythm turbulence. 3) Changes of calcium and magnesium plasma levels in smokers do not cause the ventricular extrasystole. 4) Studying of the heart rhythm turbulence is available marker of fatal arrhythmias occurrence predicting.