GÁNH NẶNG RUNG NHĨ Ở BỆNH NHÂN SUY TIM MẠN TÍNH PHÂN SUẤT TỐNG MÁU THẤT TRÁI GIẢM

Abstract

Objective: To describe the clinical, paraclinical, and 24-hour Holter ECG characteristics in patients with chronic heart failure with reduced ejection fraction (HFrEF) and atrial fibrillation (AF), and to investigate some factors associated with ventricular rate response. Methods: A cross-sectional descriptive study on 40 patients with HFrEF and AF at Bach Mai Hospital from January 2025 to July 2025. Patients underwent 24-hour Holter ECG to determine average, maximum, minimum ventricular rate, and arrhythmias. Ventricular rate response was evaluated according to RACE II criteria (≤110 beats/min). Clinical symptoms and paraclinical parameters were analyzed between the controlled and uncontrolled ventricular rate groups. Results: The prevalence of controlled ventricular rate was 85.0% (n=34). The average ventricular rate was 94.37 ± 18.58 beats/min. The mean heart rate was significantly higher in the uncontrolled group (127.0 ± 16.7 vs. 88.6 ± 11.8 beats per minute; p0.05). Conclusion: Patients with HFrEF and AF have a high rate of controlled ventricular rate. Uncontrolled ventricular rate is associated with higher ventricular rates, a trend toward higher NT-proBNP levels, and cardiac structural changes. Early identification of these clinical and paraclinical features is valuable for guiding screening and optimal treatment in patients with chronic heart failure with reduced ejection fraction and atrial fibrillation