Halil AKIN, Bernas ALTINTAŞ, Flora OZKALAYCI, Ilyas KAYA, Adem AKTAN, Ayhan KUP, Rasit ONUK, Abdulkadir USLU, Abdurrahman AKYÜZ, Hasan Ali BARMAN

Idyopatik ventriküler prematür komplexli hastalarda semptomlar ile QRS zamanı arasındaki ilişki

Amaç: Prematüre ventriküler kompleksler (PVC' ler) en sık karşılaşılan aritmilerden biridir ve tedavi edilmediğinde dilate kardiyomyopati, ventriküler taşikardi gibi ciddi komplikasyonlara neden olmaktadır. Çalışmamızda İdiopatik premature ventrikeler komplexi (IPVC) olan hastalarda QRS süresi ile semptom arasındaki ilişkiyi araştırdık. Gereç ve yöntem: Ocak 2019 ile Mayıs 2019 tarihleri arasında on dokuz farklı merkezde kardiyoloji kliniklerine başvuran 24 saatlik holter izleminde 1.000'den fazla idiyopatik PVC'si ve normal QRS süresi olan 242 ardışık hastanın dahil edildiği çok merkezli, kesitsel bir çalışmadır. Hastaların semptomlarına göre semptomatik (n: 128) ve asemptomatik (n:114) olarak 2 gruba ayrılarak QRS süreleri arasındaki ilişki araştırıldı. Bulgular: 242 hastanın yaş ortalaması 51±13’ di ve %52,4 (127)’ ü erkek cinsiyetteki hastalardan oluşmaktaydı. Semptomatik IPVC grubunda asemptomatik IPVC gruba göre sinüs QRS süresi, PVC QRS süresi, coupling intervali ve prematürite indexi istatiksel anlamlılıkla daha yüksekti. Yapılan multivariete lojistik regresyon analizinde IPVC’ li hastalarda sinüs QRS süresi ile (odds ratio (OR) = 1.3, 95% confidence interval (CI) = 1.01-1.05, p=0.002) semptom arasında anlamlı ilişki saptandı. IPVC'li hastalarda sinüs QRS süresinin semptomları öngörmedeki gücünü göstermek için yapılan ROC analizinde Area Under Curve (AUC) değeri = 0,547 %95 GA: 0.454-0.640, p = 0.320 olarak saptandı (Şekil 1). Sonuç: IPVC’ li hastalarda; uzamış sinus QRS süresi olması hastaların semptomatik olmasında diğer parametrelerden daha üstün saptanmıştır

Anahtar Kelimeler:

Idiopathic premature ventricular complex, coupling interval, QRS time

The relationship between symptoms and QRS duration in patients with idiopathic ventricular premature complex

Aim: Premature ventricular complexes are one of the most common arrhythmias and, when not treated, can cause serious complications such as dilated cardiomyopathy and ventricular tachycardia. In our study, we investigated the relationship between QRS duration and symptoms in patients with idiopathic premature ventricles complex (IPVC). Material and Methods: This is a multicenter, cross-sectional study involving 242 consecutive patients with more than 1,000 idiopathic PVC and normal QRS duration in 24-hour Holter follow-up who attended cardiology clinics in 18 different centers between January 2019 and May 2019. The relationship between the QRS durations was investigated by dividing the patients into 2 groups as symptomatic (n: 128) and asymptomatic (n: 114). Result: The average age of 242 patients was 51 ± 13 and 52.4% (127) of them were male patients. In the symptomatic IPVC group, sinus QRS duration, PVC QRS duration, coupling interval, and prematurity index were statistically significantly higher than the asymptomatic IPVC group. In the multivariate logistic regression analysis, a significant relationship was found between the sinus QRS duration (odds ratio (OR) = 1.3, 95% confidence interval (CI) = 1.01-1.05, p = 0.002) and symptoms in patients with IPVC. In the ROC analysis performed to show the power of sinus QRS duration in predicting symptoms in patients with IPVC, Area Under Curve (AUC) value was found as = 0.547 95% CI: 0.454-0.640, p = 0.320 (Figure 1). Conclusion: In patients with IPVC; The prolonged sinüs QRS duration was found to be superior to other parameters in patients being symptomatic.

Keywords:

Idiopathic premature ventricular complex, coupling interval, QRS time,

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