Журнал «Медицина неотложных состояний» 6 (61) 2014
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Effect of cardic pacemaker implantation on cognitive dysfunction in patients with bradyarrhythmias
Авторы: Stadnik S.N. - Military Medical Clinical Center, Lviv, Ukraine
Рубрики: Медицина неотложных состояний
Разделы: Справочник специалиста
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Summary. To assess the effect of cardiac pacemaker implantation on the cognitive dysfunction in patients with bradyarrhythmias, 28 patients aged 66,4±4,8 years (20 males and 8 females) were included into the study. The assessment of the neurological status and cognitive function were carried out before the pacemaker implantation and 1 month later. As the control group were surveyed 14 patients with bradyarrhythmias, for correction, which used the drug therapy. Cognitive function was assessed using neuropsychological tests: Mini Mental State Examination (MMSE), Frontal Assessment Batter (FAB), drawing test hours, 10 memory Luria test words, study of the oral-aural memory of memory Luria test 10 words, visual memory for Rybakov, active attention — on Schultetables. Psycho-emotional state was evaluated by test anxiety Spilbergera, scale Beck.
Based on the data in neuropsychological study found a significant increase in the speed of active attention, increasing the productivity of the oral-aural short-term and long-term memory, visual short-term memory in patients, which held cardic pacemaker implantation. Significantly improved emotional state of patients of control group. The findings suggest a positive effect of pacing on the ECS that influenced the improvement of ability to lower fatigue. Similar studies in the control group had less expressed the positive dynamics of the studied variables.
In patients with pacemaker implantation, prevalence and severity of cognitive disorders correlated with electrocardiostimulation (ECS) regime, cardiac arrhythmia severity and ECS complications. These factorspoint to the need for psychological rehabilitation of patients with ECS.
Thus, for patients with the bradyarrhythmias after an operation pacemaker implantation diminishing of frequency and expressed of cognitive disfunction. The analysis of the neuropsychological testing showed that meaningful predictors of cognitive disorders was clinical displays of violation of cardiac rhythm, remoteness (periods) and mode pacemaker implantation, and also development of complications cardic pacemaker implantation.