[Myocardial hypertrophy and coronary insufficiency as a cause of arrhythmia in patients with hypertension].

AIM: To elucidate contribution of left ventricular hypertrophy (LVH) vs myocardial ischemia to rhythmic disorders in patients with essential hypertension (EH) and LVH. MATERIALS AND METHODS: Echocardiography, coronarography, treadmill test, 24-h ECG monitoring were included in examination of 69, 69, 68 and 63 patients, respectively. All of them had EH stage II and LVH. The comparison was made between the groups composed by LVH degree and by the presence or absence of coronary artery atherosclerosis (CAA). RESULTS: Subjective arrhythmia was recorded in 27% of the examinees, while objective one was registered by 24-h monitoring and treadmill test in 85.7 and 42.6% of the patients, respectively. Ventricular arrhythmia in EH stage II patients with LVH is associated for the most part with coronary insufficiency, often in the presence of atherosclerosis of the coronary artery. High-grade ventricular extrasystoles by B. Lown and M. Wolf and LVH degree were related. CONCLUSION: An essential role in the onset of supraventricular arrhythmia (SVA) in EH stage 2 patients with LVH belongs to the size of the left atrium and LVH degree. SVA is related to left ventricular myocardial ischemia.