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Revista Colombiana de Cardiología

Print version ISSN 0120-5633

Abstract

LOPEZ-PATINO, Helber G. et al. Diastolic dysfunction and its relationship with arrhythmias: more than just linked to atrial fibrillation. Rev. Colomb. Cardiol. [online]. 2020, vol.27, n.5, pp.362-367.  Epub July 21, 2021. ISSN 0120-5633.  https://doi.org/10.1016/j.rccar.2020.01.012.

Introduction:

Heart failure is a public health problem, with a prevalence that increases with age. Up to 50% of cases have a preserve ejection fraction. Few studies have evaluated arrhythmias in this population type. It is known that there is an association with atrial fibrillation, but other types of arrhythmias that could be present are ignored.

Objective:

To describe arrhythmias using 24 hour Holter monitoring in patients with diastolic dysfunction.

Materials and methods:

An observational, descriptive, and retrospective study was performed in which the parameters from 24 hour Holter monitoring were evaluated and compared in patients with diastolic dysfunction from a single centre and resident in Medellin, during the year 2017.

Results:

A total of 67 patients had diastolic dysfunction, in which the majority (65.7%) were women. The mean age was 71 years, with a mean body mass index of 26.8. The most frequent comorbidities were arterial hypertension (68.7%), atrial fibrillation (19.4%), and coronary disease (19.4%). The mean ejection fraction was 58%; 67.2% had a type I diastolic dysfunction, and the mean atrial volume was 33 ml/m2. The most common arrhythmias were discontinuous atrial flutter (40.3%), atrial fibrillation (10.4%), monomorphic ventricular tachycardia (7.5%) and nodal re-entrant tachycardia (1.5%). First degree AV block (22.4%) and sinoatrial block (1.5%) were observed. The mean heart rate variability was 126.23.

Conclusions:

Several types of arrhythmias other than atrial fibrillation were documented in patients with type I and type II diastolic dysfunction. There were no changes in the heart rate variability or in the QTc time. Given the existence of a common pathophysiological background, further studies are needed in order to evaluate the relationship between arrhythmias and diastolic dysfunction, as well as any potential treatment and modification of its clinical course.

Keywords : Diastolic dysfunction; Arrhythmia; Atrial fibrillation; Ventricular tachycardia; Heart rate variability.

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