Author/Editor		Ažman-Juvan, Katja
Title		Vpliv uspešnosti trombolitičnega zdravljenja na variabilnost srčne frekvence pri bolnikih z akutnim srčnomišičnim infarktom
Type		monografija
Place		Ljubljana
Publisher		Medicinska fakulteta
Publication year		1998
Volume		str. 39
Language		slo
Abstract		Successful thrombolysis significantly reduces mortality of patients with acute myocardial infarction (AMI). The possible mechanism of such is probably related also to beneficial effect of the patency of infarct-related artery on autonomic activity. The aim of our study was to investigate the influence of thrombolysis on autonomic activity in patients with AMI. Autonomic activity was indirectly analysed by means of heart rate variability (HRV). A wavelet analysis, which is a frequency domain method, was utilised. In 63 patients with AMI HRV was determined at admission to intensive care unit, 3, 24 hours and 4-5 days after admission. Among them, thrombolysis was successful in 42 and unsuccessful in 11 patients. Ten patients, who did not receive thrombolytic treatment, comprised a control group. Patients with successful thrombolysis had higher normalised high frequency power, which is marker of parasympathetic activity. The difference became significant on day 4-5 after AMI (p=0.04). It was even more evident in patients without ventricular arrhythmias or congestive heart failure (p=0.002). No differences in any measures of HRV were found at admission, 3 and 24 hours after admission to intensive care unit. Successful thrombolysis is associated with preserved parasympathetic activity. This could be one of the mechanisms for reduced mortality in patients with successful thrombolysis. Higher parasympathetic activity namely improves electrical stability of the heart, which results in reduced occurence of malignant ventricular arrhythmias and sudden cardiac deaths.
Descriptors		MYOCARDIAL INFARCTION THROMBOLYTIC THERAPY HEART RATE AUTONOMIC NERVOUS SYSTEM INTENSIVE CARE UNITS PARASYMPATHETIC NERVOUS SYSTEM ACUTE DISEASE