RESUMO
Aim of this observational study was assessment of effect of variability of glycemia on ventricular ectopic activity in patients with chronic heart failure (CHF) and type 2 diabetes mellitus (n=80). According to study protocol 24-hour Holter ECG monitoring was carried out at baseline, and after 3 and 6 months. Measurements of blood glucose level were made at 8 points during ECG monitoring - before and in 2 hours after main meals, before bedtime and at 3 o'clock in the morning. In 20 patients continuous combined monitoring of ECG and of blood glucose level was carried out. During monitoring of ECG high grade ventricular arrhythmias were found in 42 patients (53%). Pronounced variations of blood glucose level (mean amplitude of glycemic excursion >5 mmol/L) were associated with 2.3 fold increase risk of ventricular arrhythmias (p=0.04). A conclusion was made that pronounced 24-hour variations of glucose level in blood was associated with elevation of ventricular ectopic activity. High 24-hour variability of glycemia appeared to be proarrhythmogenic factor in patients with CHF and concomitant diabetes.
