Pochynska M. Values of pulse pressure classes in medicamentous control of patients with implanted permanent pacing and cardioresynchronization therapy.

The thesis work is devoted to establishing the connection between pulse arterial pressure and diagnostic efficiency and medicamentous therapy of patients with implanted cardiac pacemaker. The thesis research determines the significance of pulse pressure level through improving the quality of diagnostics and drug treatment of patients with the implanted cardiac pacemakers (CPM) and cardioresynchronization therapy therapy. 215 patients (70 ± 9 years old) were examined before implantation, during early post implant period and in 6 and 12 months after implantation, and divided into 5 pulse pressure classes. The normal pulse pressure level before CPM implantation was found among 32% of patients, high - among 33%, and very high - among 35%. The increase of pulse pressure level was associated with the increase of incidences of postinfarction cardiosclerosis and atrial fibrillation (in 5 times), stable angina and arterial hypertension (AH) (in 4 times), diabetes mellitus type II (in 2 times) and chronic heart failure (CHF) (in 3 times). It was demonstrated that more often prescription of basic antihypertensive drugs and escalation of diuretics and beta-blockers dose for patients with increased pulse pressure after CPM implantation was associated with its normalization among 74% of patients. The drug treatment together with implantation promoted the reduction of incidences of initially high functional classes of stable angina, severity of AH, CHF stages and FC mainly in case of normal and high pulse pressure level.