Estimation of asymptomatic arrhythmias Cardiac in patients with left breast cancer at the stage of radiotherapy
Background. Prevention of cardiovascular complications in women with left breast cancer is of particular importance in connection with direct radiation exposure to the heart. Among the most frequent and prognostically adverse complications are arrhythmias after anticancer therapy. Purpose and tasks: to evaluate the diagnostic possibilities of using Holter electrocardiographic monitoring (HM) in women with left breast cancer to detect cardiac arrhythmias and conduction that occur asymptomatic at the stage of radiation therapy. Material and methods: 68 women with HER2neu negative left breast cancer were examined at the stage of 3D conformal radiotherapy on the bed of the left breast SOD 39 Gy (equivalent to 48 Gy of normal functioning). The mean age was 53.4±4.9 years. All the patients at the previous stages had a Madden mastectomy followed by doxorubicin therapy in a cumulative dose not exceeding 360 mg/m2. In all the examined patients there were no complaints and no indication of rhythm in history. The examination included ECG, echocardiography and HM. Results: at the stage of preparations for the radiation treatment of arrhythmia detected in 95.6% of patients, most of which the number and nature of the arrhythmia was non pathological. After radiation therapy, a significant increase in the incidence of pathological atrial arrhythmias (more than 100 per hour), short paroxysms of atrial fibrillation, single pathological ventricular arrhythmias and group polymorphic ventricular arrhythmias was revealed. Conclusions: the conduct of HM allowed us to identify abnormalities of cardiac rhythm and conduction in most patients with cancer of the left breast during radiation therapy. The results of the study indicate the importance of diagnostic information obtained with the help of HM for the development of a personalized approach to the further prevention and treatment of arrhythmias due to cardiotoxicity.