КардиоСоматика (Sep 2020)
Telemetric electrocardiography in diagnostics of cardiotoxic heart rhythm disorders and conductivity in oncologic patients
Abstract
Aim.Assessment of the possibility to use ECG-telemetry in order to increase the efficiency of cardiotoxic effect diagnosis in cancer patients with chemotherapy. Material and methods.Remote dynamic monitoring for 6 months was carried out in 31 cardio-oncological patients (in 17 prostate cancer (PC), in 14 breast cancer (BC), mean age was 53.6 (50.1; 56.8) years and 48.3 (38.8; 57.1) years, respectively; FC NYHA IIII; left ventricular ejection fraction 47.4% (40.2; 57.3) and 43.2% (39.7; 58.9), respectively; Mini-Mental State Examination from 30 to 24 points 27.6 (25.4; 29,1) and 28.2 (25.1; 28.8), respectively. ECG-telemetry was performed according to the principle of auto-translation using individual ECG recorders, mobile devices and the ECG Dongle Internet application (Nordavind-Dubna, Russia). Storage, analysis of information and telemedicine consultation was perfomed with the CardioСloud asynchronous tele-cardiological platform. ECG was registered with a frequency of at least 5 times/day and additionally repeatedly in the presence of symptoms and patient desires, duration 1020 minutes. Results.Previously undocumented ECG changes were remotely recorded in patients for 6 months of follow-up: in 87.0% of patients sinus tachycardia, against which ventricular extrasystole of various gradations (32.3%), supraventricular extrasystole (22.6%), transient tachy-dependent blockade of the bundle of His legs were recorded (9.7%). In 64.7% of PC patients and in 42.8% of BC patients rhythm disturbances were detected in combination with depression of theSTsegment. Paroxysms of atrial fibrillation were reported in 17.6% of PC patients and in 14.3% BC patients. In 35.5% of patients the detected ECG changes were asymptomatic. Conclusion.Remote dynamic monitoring in cancer patients receiving chemotherapy involving ECG recording scheme (5 times/day, 1020 min) with ECG telemetry is an effective and unexpensive method for detecting ECG changes in the phenomenon of cardiotoxicity.
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