DETECTION AND EVALUATION OF ARRHYTHMIAS IN PATIENTS WITH LEFT BREAST CANCER AT THE STAGE OF RADIATION THERAPY

Prevention of cardiovascular complications in women with left breast cancer is particular importance in connection with direct radiation exposure to the heart. Despite the growing concern of cardiologists about long term complications from radiotherapy (RT), the direct effects at the stage of this method have not been studied enough. Purposes and tasks: Detection and evaluation of asymptomatic arrhythmias using daily Holter ECG monitoring (HM) at the stage of RT in women with left breast cancer. Materials and methods: 68 women without a history of severe cardiovascular disease with HER2neu negative cancer of the left breast at the stage of 3D conformal radiotherapy were examined. Mean age 53.6±4.6 years (95% CI: 46.8-69.3). All patients at the previous stages were carried out mastectomy Madden followed by therapy with doxorubicin. The examination included ECG registration, HM and echocardiography. Results: according to the results of HM ECG arrhythmias were detected in 63 (92.6%) patients. After the end of RT, the number of patients with frequent supraventricular extrasystole significantly increased compared to the baseline level (p=0.032). The proportion of patients with non pathological ventricular arrhythmias after completion of LT decreased due to an increase in the number of patients with pathological ventricular disorders (grade II-IVA). In the absence of contractility reduction in 16 (23.5%) patients asymptomatic restrictive type of diastolic dysfunction of was revealed. Conclusion: Holter monitoring allows to detect in a large percentage of cases of violation of atria and ventricles ectopic activity in women with left breast cancer at the stage of LT 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 as a manifestation of cardiotoxicity.