Análise de distúrbios do ritmo em pacientes com doença arterial coronariana em programas de reabilitação cardiovascular

Abstract

Background: There is still no relationship between cardiac arrhythmias and the rehabilitation of physical activity in cardiac programs (PRC). Physiotherapists are prepared to work auxiliary with greater safety to the PRC. There is still no relationship between cardiac arrhythmias and the rehabilitation of physical activity in cardiac programs (PRC). Physiotherapists are prepared to work auxiliary with greater safety to the PRC However, the study of arrhythmias before, during and after a rehabilitation session is still incipient and investigations related to this topic can help physicians and physical therapists to ensure greater safety for CRP. Objectives: To assess rhythm disturbances in patients with coronary insufficiency (COI) before, during and after a CRP session. Methods: In this cross-sectional, non-randomized, open-label study, data from 69 patients were evaluated (Age=65.3±9.6 years; Body Mass Index=29.1±4.3 Kg/m2 and Ejection Fraction of 64.0±8.2%) with a clinical diagnosis of ICO inserted in a CRP. After initial evaluation for characterization, patients were connected to a holter (Cardio Sistemas) with three leads and had their heart rhythm recorded before (60 min), during and after (60 min) a CRP session. The recorded record was analyzed by an arrhythmia analysis module on a computer, coupled to the CardioSmart Professional CS 540 analyzer, by an arrhythmologist cardiologist. Descriptive statistics, Friedman's test and sperman correlation were used for data analysis (p<0.05). Study approved by the Ethics Committee (CAAE: 31549620.3.0000.5515).Results: In the patients analyzed, systemic arterial hypertension (78.3%) and family history (78.3%) were the most prevalent comorbidities and antiplatelet agents (82.6%) and statins (58%) were the most used drugs. Before the session, 78% of the patients had some rhythm disturbance. Isolated ventricular (55.6%) and isolated supraventricular (72.2%) ectopias were the most prevalent disorders. Supraventricular and ventricular tachycardias were seen in 4.3 and 1.4%, respectively. Although not significant, there was a reduction in the number of rhythm disturbances during the session and a return to the resting condition in the recovery period. At rest and recovery, a negative correlation was observed between ejection fraction and isolated and paired ventricular ectopias, the same occurring with bigeminism in recovery. Conclusion: Patients with ICO on CRP have a high prevalence of rhythm disorders. The number of disturbances decreased during the CRP and negative correlations were observed between ejection fraction and rhythm disturbances.