Pattern of arrhythmias among Nigerians with congestive heart failure

Abstract

Olufemi E Ajayi,1 Olugbenga O Abiodun,1 Anthony O Akintomide,1 Rasaaq A Adebayo,1 Suraj A Ogunyemi,1 Michael O Balogun,1 Olaniyi J Bamikole,1 Adeola O Ajibare,1 Adesuyi A Ajayi2,3 1Cardiac care unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria; 2Texas Southern University, Houston, TX, USA; 3The Saba University School of Medicine, The Bottom, Saba, Dutch Caribbean Background: In patients with heart failure, death is often sudden due to life-threatening arrhythmias. This work was carried out to evaluate the pattern of arrhythmias in Nigerians with heart failure. Materials and methods: Thirty subjects with congestive heart failure (CHF), 30 subjects with hypertensive heart disease, and 15 normal subjects with no obvious features of heart disease were evaluated with resting and 24-hour electrocardiographic monitoring and transthoracic echocardiography. Data were analyzed with one-way analysis of variance with post hoc Duncan’s analysis, Fisher’s exact test, and linear regression analysis using SPSS version 16. Results: CHF subjects had more instances of supraventricular tachycardia (P=0.005), ventricular extrasystoles (P<0.001), bigeminy (P<0.001), trigeminy (P<0.001), couplets (P<0.001), triplets (P<0.001), and nonsustained ventricular tachycardia (VT) (P=0.003) than the other two control groups. They also showed a significantly longer VT duration (4.6±5.6 seconds) compared with the other groups (P<0.001). Linear regression analysis showed a significant direct relationship between VT and the maximum number of ventricular extrasystoles per hour (P=0.001). Conclusion: Cardiac arrhythmias are common in subjects with CHF and are more frequent when compared with patients with hypertensive heart disease and normal subjects. Keywords: arrhythmias, heart failure, hypertensive heart disease, Nigerians