[Disorders of heart rhythm and conduction in dilated and hypertrophic cardiomyopathies]
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Patients with dilated cardiomyopathy (DCMP) experience more severe heart rhythm abnormalities than those with hypertrophic cardiomyopathy (HCMP). These arrhythmias, including atrial fibrillation and ventricular tachycardia, are more frequent and prognostically unfavorable in DCMP patients.
Area of Science:
- Cardiology
- Electrophysiology
- Internal Medicine
Context:
- Idiopathic cardiomyopathies present with diverse clinical symptoms, most commonly heart rhythm abnormalities.
- Dilated cardiomyopathy (DCMP) and hypertrophic cardiomyopathy (HCMP) are distinct forms of myocardial disease.
- Distinguishing the patterns and severity of arrhythmias in DCMP versus HCMP is crucial for patient management.
Purpose:
- To quantitatively and qualitatively evaluate heart rhythm abnormalities in patients with DCMP and HCMP.
- To compare the prevalence and characteristics of arrhythmias between DCMP and HCMP cohorts.
- To assess the prognostic implications of observed arrhythmias in these cardiomyopathy subtypes.
Summary:
- Daily ECG monitoring revealed frequent arrhythmias in both DCMP and HCMP patients.
- Atrial fibrillation, supraventricular, and ventricular arrhythmias were more prevalent and severe in DCMP.
- AV conduction abnormalities were also more common in DCMP patients.
- Ventricular arrhythmias, including paroxysmal tachycardia, were significantly higher in DCMP (55%) compared to HCMP (16.7%).
Impact:
- Heart rhythm abnormalities are common in both DCMP and HCMP.
- Arrhythmias in DCMP are generally more severe and carry a worse prognosis.
- Findings highlight the need for vigilant cardiac rhythm monitoring in DCMP patients.
Abstract:
Idiopathic cardiomyopathies are characterized by diversity of clinical manifestations, among which heart rhythm abnormalities are the most common. The authors carried out qualitative and quantitative evaluations of heart rhythm abnormalities in patients with dilated and hypertrophic cardiomyopathies (DCMP, HCMP) and compared those abnormalities according to the data of daily ECG monitoring. Forty patients with DCMP and 30 with HCMP were examined. In 8 (25%) patients with DCMP and in 2 (6.7%) with HCMP, permanent atrial fibrillation was recorded. Among patients with sinus rhythm, supraventricular premature heart beats were found in 30 (96.8%) patients with DCMP and in 24 (85.7%) with HCMP. However, their number during 24 h exceeded 500 in 9 (29%) and in 7 (25%) patients, respectively. Supraventricular paroxysmal tachycardia (greater than or equal to 3 complexes at HR greater than or equal to 100/min) was recorded in 7 (22.6%) patients with DCMP and in 4 (14.3%) patients with HCMP. Ventricular premature heart beats were recorded in 38 (95%) patients with DCMP and in 21 (70%) patients with HCMP, polytopic in 31 (77.5% and 17 (56.7%), coupled in 227 (67.5%) and 10 (33.3%), ventricular paroxysmal tachycardia (greater than or equal to 3 complexes at HR greater than or equal to 100/min) in 22 (55%) and 5 (16.7%) patients, respectively. AV conduction abnormalities among patients with sinus rhythm were noted in DCMP and HCMP, in 12 (38.7%) and 1 (3.6%) cases, respectively. Thus, heart rhythm abnormalities are often encountered in both patients with DCMP and HCMP. However, in patients with DCMP, heart arrhythmias are graver and prognostically unfavourable.(ABSTRACT TRUNCATED AT 250 WORDS)