Clinical assessment of bradiarithmyin adolescents and persons of the military age

Authors: Klubkova I.A.2, Avdeeva M.V.2, Ivleva O.V.1

Company: 1Bakoulev National Medical Research Center for Cardiovascular Surgery of Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation;
2 St. Petersburg State Pediatric Medical University of Ministry of Health of the Russian Federation, ulitsa Litovskaya, 2, Saint-Petersburg, 194100, Russian Federation

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Type:  Оригинальные статьи


DOI: https://doi.org/10.24022/1997-3187-2018-12-3-236-249

For citation: Klubkova I.A., Avdeeva M.V., Ivleva O.V. Clinical assessment of bradyarrhythmia in adolescents and persons of the military age. Creative Cardiology. 2018; 12 (3): 236–49 (in Russ.). DOI: 10.24022/1997-3187-2018-12-3-236-249

Received / Accepted:  21.06.2018/19.07.2018

Keywords: adolescents bradycardia bradysystole bradyarrhythmia military age

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Abstract

Objective. To study clinical features of bradyarrhythmia in adolescents and people of military age sent by military medical commissions to multidisciplinary hospital for medical examination.

Material and methods. The study included 2067 patients aged 16–26 years (mean age 19.7±2.7 years). In those with bradycardia (n=630), additional examination was performed (24-hour ECG monitoring, echocardiography, treadmill test, heart rate variability analysis, respiratory test, laboratory tests).

Results. Most often, normosystolia was recorded (61.2%), bradycardia (30.5%) and tachycardia (8.3%) were less common. Complaints of a vascular nature (headaches, dizzines, syncope) were observed in 76.0% of patients with bradycardia. It was associated with increased systolic blood pressure (r=0.54, p<0.05), decreased maximum oxygen consumption (r=–0.49, p<0.05), decreased heart rate (r=–0.42, p<0.05), increased left ventricular ejection fraction (r=0.39, p<0.05), smoking (r=0.35, p<0.05), increased stroke volume of left ventricle (r=0.34, p<0.05), heart rhythm disturbances (r=0.28, p<0.05); increased activity of the parasympathetic nervous system (r=0.26, p<0.05), increased body mass index (r=0.24, p<0.05). Complaints of asthenic nature disturbed 62.5% of patients with bradycardia. Their appearance was due to inefficient feeding (r=0.76, p<0.05), smoking (r=0.67, p<0.05), stigma of connective tissue dysplasia (r=0.54, p<0.05), low heart rate (r=–0.46, p<0.05), high body mass index (r=–0.43, p<0.05), heart rhythm disturbances (r=0.38, p<0.05), decreased level of effort performed during physical exertion (r=–0.45, p<0.05) and other factors. Cardiac syndrome was found in 61,7% of patients with bradycardia, and its appearance was due not only to hemodynamic factors, but also to smoking (r=0.67, p<0.05), increased sympathetic (r=0.42, p<0.05) or parasympathetic (r=0.41, p<0.05) tones, chest deformation (r=0.33, p<0.05), and other factors.

Conclusions. A comprehensive examination of adolescents and people of military age with bradycardia allows you
to assess the functional state of the cardiovascular system in order to resolve the issue of fitness for military service.

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About Authors

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery