ADDITIONAL OPPORTUNITIES FOR EVALUATING THE CONDITION OF CORONARY RESERVE IN TRANSESOPHAGEAL STUIMULATION TEST

Abstract

Peculiarities of programmed through-oesophagus electrocardiostimulation (PTOECS) in 84 coronary patients and 35 healthy have been studied with the purpose of exposure of new additional criterions of lowering of coronary reserve (CR). It was discovered that 22,8% of healthy people and 38,1% patients with coronary patology by PTOECS had signs of blocades of fasciculus atrioventricularis (BFAV) at the moment of achievement of reflexity of miocardium, which were present on the background of lowered CR in cases of patology. Healthy people had the presence of this phenomenon more often in ombination with high level of conductivity in atrioventricular (AV) combination by that. On the contrary, coronary patients with BFAV had blocades of conducting accompanied by essential prolongation of effective refractering period, compared to analogue subgroup of healthy persons (correspondingly, 258,6±15,4 and 232,1±12,8 mls?; p<0,01). Time of preservation of BFAV (period of ”vulnerability”)appeared to be significantly longer in patients, compared to healthy people (correspondingly, 91,8±8,3 and 18,4±2,1ms; p<0.001). Significant prolongation of a period of “vulnerability “ was noted at the same time with the grouth of the dangerousness of illness; combination of BFAV with hidden disturbance of conductivity in AV combination was noted in case of appearance of ishemic threshold on low frequencies of stimulation. The conclusion about possibility of using of parameters studied by PTOECS for specification of presence and grade of dangerousness of CR, was drawn.