Telemetric electrocardiography in diagnostics of cardiotoxic heart rhythm disorders and conductivity in oncologic patients

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Abstract


Aim. Assessment of the possibility to use ECG-telemetry in order to increase the efficiency of cardiotoxic effect diagnosis in cancer patients with chemotherapy.

Material and methods. Remote dynamic monitoring for 6 months was carried out in 31 cardio-oncological patients (in 17 – prostate cancer (PC), in 14 – breast cancer (BC), mean age was 53.6 (50.1; 56.8) years and 48.3 (38.8; 57.1) years, respectively; FC NYHA I–III; left ventricular ejection fraction 47.4% (40.2; 57.3) and 43.2% (39.7; 58.9), respectively; Mini-Mental State Examination from 30 to 24 points – 27.6 (25.4; 29,1) and 28.2 (25.1; 28.8), respectively. ECG-telemetry was performed according to the principle of auto-translation using individual ECG recorders, mobile devices and the ECG Dongle Internet application (Nordavind-Dubna, Russia). Storage, analysis of information and telemedicine consultation was perfomed with the CardioСloud asynchronous tele-cardiological platform. ECG was registered with a frequency of at least 5 times/day and additionally repeatedly in the presence of symptoms and patient desires, duration 10–20 minutes.

Results. Previously undocumented ECG changes were remotely recorded in patients for 6 months of follow-up: in 87.0% of patients – sinus tachycardia, against which ventricular extrasystole of various gradations (32.3%), supraventricular extrasystole (22.6%), transient tachy-dependent blockade of the bundle of His legs were recorded (9.7%). In 64.7% of PC patients and in 42.8% of BC patients rhythm disturbances were detected in combination with depression of the ST segment. Paroxysms of atrial fibrillation were reported in 17.6% of PC patients and in 14.3% BC patients. In 35.5% of patients the detected ECG changes were asymptomatic.

Conclusion. Remote dynamic monitoring in cancer patients receiving chemotherapy involving ECG recording scheme (≥5 times/day, 10–20 min) with ECG telemetry is an effective and unexpensive method for detecting ECG changes in the phenomenon of cardiotoxicity.


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About the authors

Nadezhda P. Lyamina

Moscow Centre for Research and Practice in Medical Rehabilitation, Restorative and Sports Medicine

Author for correspondence.
Email: lyana_n@mail.ru

Russian Federation, Moscow

D. Sci. (Med.), Prof., Moscow Centre for Research and Practice in Medical Rehabilitation, Restorative and Sports Medicine

Irena V. Pogonchenkova

Moscow Centre for Research and Practice in Medical Rehabilitation, Restorative and Sports Medicine

Email: lyana_n@mail.ru

Russian Federation, Moscow

D. Sci. (Med.), Moscow Centre for Research and Practice in Medical Rehabilitation, Restorative and Sports Medicine

Svetlana V. Lyamina

Yevdokimov Moscow State University of Medicine and Dentistry

Email: lyana_n@mail.ru

Russian Federation, Moscow

D. Sci. (Med.), Prof., Yevdokimov Moscow State University of Medicine and Dentistry

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