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ECG changes during endoscopic procedures in upper gastrointestinal tract


Authors: M. Makovník 1;  Ľ. Gašpar 1;  S. Hlinšťáková 1;  Ľ. Lukáč 2;  J. Lietava 1;  A. Dukát 1
Authors‘ workplace: II. interná klinika Lekárskej fakulty UK a UN Bratislava, Slovenská republika Prednosta: doc. MUDr. Ľudovít Gašpar, CSc. 1;  I. interná klinika Lekárskej fakulty UK a UN Bratislava, Slovenská republika Prednosta: doc. MUDr. Soňa Kiňová, PhD. 2
Published in: Prakt. Lék. 2012; 92(3): 145-149
Category: Of different specialties

Overview

Aim of the study:
To compare Holter electrocardiography (ECG) record in patients during endoscopic procedure with the period in which patients carry out their usual activities and to evaluate the cardiovascular response to endoscopic procedure.

Methods:
Ambulatory 24-hour ECG monitoring by Holter was used to detect ischemia and dysrhythmias. The actual endoscopic procedure (gastroduodenoscopy or endoscopic retrograde cholangiopancreatography ERCP) was performed during this period.

Patients:
We investigated a group of 116 persons, which, with its characteristics, constitutes a representative selection of patients undergoing elective upper gastrointestinal endoscopy procedures in the endoscopic department of a general hospital in Bratislava.

Results:
We found a high prevalence of ischemia (17.2 %) and complex forms of cardiac dysrhythmia - Lown III-V (12.9 %) during the endoscopic procedure.

Significant myocardial ischemia, which didn’t occur during the rest of the monitoring period, was recorded during the endoscopic procedure in 7.8 % of patients.

Higher class of complex forms of ventricular ectopic beats (by Lown’s classification) during the endoscopic procedure was recorded in 7.4% of patients when compared to the rest of the period, a lower class was recorded in 20.7% of patients.

Conclusions:
Based on the results, we found that anti-ischaemic and anti-dysrhythmic therapies are protective factors for ischemia and dysrhythmia during upper gastrointestinal endoscopy. It is therefore important that the patient does not miss these therapies in preparation for the endoscopic procedure.

Key words:
gastroscopy, Holter ECG monitoring, arrhythmias, ischaemia.


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