ERYTHROCYTE MEMBRANE ADRENOREACTIVITY IN CHILDREN WITH DRUG-RESISTANT VENTRICULAR EXTRASYSTOLE BEFORE AND AFTER RADIOFREQUENCY ABLATION

Abstract

HighlightsFor children aged 11–15 years with the duration of ventricular arrhythmias from 1 to 2 years, the increased value of β-adrenergic reactivity of erythrocyte membranes (β-ARM) is characteristic in comparison with the group of healthy children of the same age, which indicates desensitization of β-adrenoreceptors. In the early postoperative period after the elimination of ventricular ectopic focus as a result of radiofrequency ablation β-ARM continues to increase. The possibility of using the β-ARM index to assess the state of the sympathetic part of the autonomic nervous system in the category of patients with methodological limitations of heart rate variability analysis was studied. AbstractAim. To evaluate the activity of the autonomic nervous system by changes in β-adrenoreactivity of erythrocyte membranes (β-ARM) in children with drug-resistant ventricular arrhythmia (VA) before and three days after radiofrequency ablation (RFA).Methods. The study included 11 children aged 13 [11;15] years old with drug-resistant ventricular arrhythmia, who had documented ventricular extrasystoles (VE) with ectopic activity exceeding 10%, including those accompanied by episodes of ventricular tachycardia (VT) (ZHA group). The control group consisted of 11 children 14 [12;16] years old who did not have the pathology of the cardiovascular system. Determination of β-ARM of erythrocytes in blood samples was performed using the BETA-ARM AGAT reagent kit (AGAT LLC, Russia).Results. At the time of hospitalization in the VA group the β-ARM indicator was significantly (p = 0.026) higher than the values in the control group. 3 days after RFA in children with VA the median β-ARM increased by 62.3% compared to the initial values in the group (p = 0.027).Conclusion. Children with VA and an arrhythmological history of more than 1 year are characterized by a predominance of activity of the sympathetic division of the autonomic regulation of the cardiovascular system. The systemic nature of the predominance of sympathetic influence is manifested in an increase in the β-ARM index relative to control values. In the early postoperative period, after the elimination of the ventricular ectopic focus as a result of RFA, an increase in β-ARM occurs, which indicates desensitization of adrenergic receptors, which also contributes to a decrease in the influence of the sympathetic system. The study demonstrated the possibility of using the β-ARM indicator to assess the response of the sympathetic system in a category of patients with methodological limitations in HRV analysis.