EFFECTIVENESS AND SAFETY OF THE USE OF SOME CLASS 1C DRUGS IN THE TREATMENT OF HEART RHYTHM DISORDERS IN WOMEN WITH CLIMACTERIC DISHORMONAL CARDIOMYOPATHY

Abstract

Background. The problem of improving therapeutic approaches to drug treatment of secondary cardiomyopathies in menopausal women based on evidence-based medicine is an extremely urgent task. Aims. To assess the efficacy and safety of the antiarrhythmic drugs ethacizine and propafenone in the treatment of secondary dyshormonal cardiomyopathy in menopausal women with cardiac arrhythmias. Materials and methods. 62 women (mean age 49.7 ± 5.8 years) were exa mined without coronary artery disease according to the results of coronary angiography, but with secondary dyshormonal cardiomyopathy. The effectiveness of antiarrhythmic therapy was assessed by the results of Holter monitoring on days 7–10 after the start of treatment with antiarrhythmic drugs. Depending on the prescribed drug, the patients were divided into 2 groups. The first group consisted of 33 patients (mean age 49.6 ± 6.8 years) who received etacizin 150 mg per day for supraventricular and ventricular extrasystoles. The second group consisted of 29 patients (mean age 50.4 ± 7.16 years) who received propafenone 600 mg per day for supraventricular and ventricular extrasystoles. Initially, the groups were similar in terms of the number of rhythm disturbances. Results. Against the background of treatment in the 1st group, the number of ventricular extrasystoles decreased by 9.9 times (from 9321.7 ± 133.7 to 937.2 ± 232.4 episodes per day; p < 0.01), and in the 2nd group — by 5.7 times (from 8668.2 ± 214.5 to 1514.3 ± 175.7 per day; p < 0.01). In group 1, the number of paired and group ventricular extrasystoles, «jogging» of unstable ventricular tachycardia decreased by 4.6 times (from 97.9 ± 24.2 to 21.7 ± 7.5 episodes per day; p < 0,01), and in the 2nd group — 1.4 times (from 111.3 ± 25.8 to 78.7 ± 11.5 episodes per day; p < 0.01). In patients of the 1st group, the total number of supraventricular extrasystoles decreased by 12.7 times (from 10685.4 ± 383.5 to 837.3 ± 78.3 per day; p < 0.01), and in the 2nd group — by 9.4 times (from 8972.6 ± 314.5 to 954.62 ± 154.3 per day; p < 0.01).
Etatsizin had a more pronounced clinical effect for the relief of supraventricular cardiac arrhythmias compared with ventricular ones (100 % and 93.9 %; χ2 = 7.25; p = 0.0071). Compared to propafenone, etacysine had a more pronounced clinical effect for the relief of supraventricular (100.0 % and 79.4 %; χ2 = 23.4; p < 0.001) and ventricular arrhythmias (93.3 % and 82.8 %; χ2 = 4.8; p < 0.05). It should be noted that in the 1st group of women, no proarrhythmic effect was observed during treatment with etacizine, and in the treatment with propafenone, in 10.3 % of cases, a proarrhythmic effect was obtained in the form of an increase in the number of ventricular extrasystoles (χ2 = 10.58; p < 0.001). Conclusion. The data obtained indicate a higher efficacy and safety of the use of etacizin in comparison with propafenone in the treatment of women with menopausal dyshormonal cardiomyopathy.