ĐẶC ĐIỂM RỐI LOẠN NHỊP TIM TRÊN HOLTER ĐIỆN TÂM ĐỒ 24 GIỜ Ở BỆNH NHÂN SUY TIM PHÂN SUẤT TỐNG MÁU THẤT TRÁI <50% TẠI BỆNH VIỆN ĐA KHOA HÀ ĐÔNG

Abstract

Objectives: To investigate the characteristics of cardiac arrhythmias detected by 24-hour Holter monitoring and their associations with plasma NT-proBNP levels and Left Ventricular Ejection Fraction (LVEF) in heart failure patients with LVEF <50% at Ha Dong General Hospital. Subjects and Methods: A cross-sectional descriptive study was conducted on 70 patients with heart failure, LVEF < 50% at the Department of Cardiology, Ha Dong General Hospital, during the period from June 2024 to July 2025. All patients underwent 24-hour Holter e monitoring recording and analysis, as well as echocardiography using the Simpson method at the time of admission. Results: The mean age of the study population was 64.8 ± 14.4 years, with the age group above 70 years accounting for the highest proportion (39%). Male patients represented a higher proportion (61.4%) compared with females (38.4%). Holter 24‑hour electrocardiographic monitoring revealed that 60% of patients had supraventricular arrhythmias. Among these arrhythmias, premature supraventricular contractions were the most frequent (55.7%), followed by atrial fibrillation (32.9%), while supraventricular tachycardia occurred at a lower rate (5.7%). Ventricular arrhythmias were common, occurring in 75.7% of patients. Of these, Lown grade 1 was most prevalent (27.1%), followed by grade 4 (22.9%), grade 2 (20.0%), and grade 3 (5.7%); no patients exhibited grade 5 arrhythmias. Plasma NT‑proBNP concentrations in patients with supraventricular arrhythmias (12,082.79 ± 440.18 pg/mL) were significantly higher than in those without supraventricular arrhythmias (9,344.75 ± 252.97 pg/mL). There was no significant difference in NT‑proBNP levels between patients with and without ventricular arrhythmias. Patients with NT‑proBNP ≥ 500 pg/mL had higher rates of overall supraventricular arrhythmias and premature supraventricular contractions than those with NT‑proBNP < 500 pg/mL. Patients with LVEF ≤ 35% had higher rates of supraventricular arrhythmias and premature supraventricular contractions than those with 35% < LVEF < 50%. Conclusion: Sixty percent of patients had supraventricular arrhythmias, and 75.7% had ventricular arrhythmias. Plasma NT‑proBNP levels were significantly higher in patients with supraventricular arrhythmias than in those without. Patients with LVEF ≤ 35% exhibited higher rates of supraventricular arrhythmias and premature supraventricular contractions than those with 35% < LVEF < 50%.