[The incidence and pattern of cardiac rhythm and conduction disturbances in patients with different clinical and pathogenetic types of hypertensive disease].

In 237 patients with grades I-III hypertensive disease, the incidence and pattern of cardiac rhythm and conduction disturbances were studied in various clinical and pathogenetic types of the disease. By taking into account the known clinical, laboratory, and hemodynamic criteria, the patients were profiled by the following types: 62 (26.2%) patients with a hyperadrenergic type, 61 (25.7%) with a hyperhydration types, 60 (25.3%) with a hyperrenin type, and 54 (22.8%) with a calcium-dependent type. Bicycle ergometric exercise test, daily ECG monitoring, and a transesophageal electrophysiological study of the heart were performed to detect latent, routine ECG-unverified cardiac rhythm and conduction disturbances. In the total group of patients, cardiac arrhythmia and block occurred in 55.3% of the cases, including in 55.7% they are latent. Cardiac rhythm disturbances were most frequently detected in the hyperadrenergic and hyperrenin variants of the disease (50.0 and 43.3%, respectively). Premature beats and paroxysmal supraventricular tachyarrhythmias were predominantly diagnosed in the hyperadrenergic type of HD; intraventricular conduction disturbances and extrasystolic arrhythmia were in the hyperhydration type; the sick sinus syndrome and atrioventricular blocks were in the hyperrenin type. The above cardiac rhythm and conduction disturbances were equally characteristic for the calcium-dependent type of the disease. There was a direct correlation between the detection rate of cardiac arrhythmia and block and the degree of a risk for cardiac and cerebral events, as well as left ventricular hypertrophy. Thus, the study of the incidence and pattern of cardiac arrhythmias associated with hypertensive disease is of importance for choosing an effective and safe treatment; and their existence should be borne in mind to stratify a risk of prognosis.