Abstract:
Introduction: In recent decades the rheumatism is decreasing. The number of patients affected by
rheumatic heart disease failure in the world reaches 15.6 million, and annually are registered about
470000 new cases.The rhythm disturbance is common in these patients. The atrialfibrillation is described
in medical literature as the most frequent arrhythmia in patients with mitral valve involvement. In mitral
stenosis the prevalence of atrial fibrillation increases with age. It is known that the atrial fibrillation is present in 10% of patients aged up to 30 years, while the age over 50 years its reaches till 50% cases.
Objectives: To analyze the characteristics of arrhythmia in rheumatic heart disease at patients hospitalized in the Institute of Cardiology from Republic of Moldova.
Methods: In the study where included 24 patients with defined diagnosis of rheumatic heart disease,
18 (75%) men and 6 (25%) women, median age 58 years old (range 41-75), 12 (50%) patients with mitral
valve disease, 7 (29.1%) patients with aortalvalve disease, and 5 (20.8%) patients with associated involvement. We analyzed the patients’ complaints, disease history, and the results of the clinical and laboratory
examination, the Electrocardiography (ECG) in the resting position, transthoracicechocardiography
(EcoCG), Doppler EcoCG.
Results: In the study group were prevailed patients from countryside-16 (66.6%) patients versus 8
(33.3%) patients from urban space. The data analysis showed that V2 (50%) of the patients suffered acute
rheumatic fever in childhood (ARF). The common complaints at admission were dyspnea in 20 (83.3%)
cases, peripheral edema at 15(62.5%), patients with syncope 3 (12.5%). The ECG evaluation showed the
atrial fibrillation (AF) at 16 (66.6%) patients, included 7 (29.1%) with chronic atrial fibrillationform and4
(16.6%) patients hadatrial paroxysmal fibrillation. Theatrial flutter and the extrasystolies where found
less 3 (12.5%) and 2 (8.3%) patientsrespectively. The conductibility disturbance certified in 9 (37.5%)
patients, including left branch block5 (20.8%) patients, rightbranch block3 (12.5%) patients, and the
atrio-ventricular block 1 (4.16%) patient. TheEcoCG analysis confirmed the structural changes on valves:
mitral valve stenosisin 8 (33.3%) patients, mitral valve regurgitation with different degrees- 4 (16.6%)
patients, aortic orifice stenosis-4 (16.6%)patients, and the aortic regurgitation- 3 (12.5%) patients, the tricuspid valve regurgitation in 3 (12.5%) patients.The cardiomegaly has been found in 13 (54.1%) patients,
more frequently left atrium dilatation at 9 (37.5%) patients.
Conclusion: The atrial fibrillation was the most frequent arrhythmias in our study group certified at
2/3 of patients, predominantly chronic form at patient with mitral valve involvement.
