Method of predicting development of acute foetus hypoxia in labour
SUBSTANCE: invention relates to medicine, namely to obstetrics and gynaecology. After anamnesis analysis, the presence of the foetoplacental failure of a compensated form, oligohydramnios are identified. The day before labour cardiotocographic (CTG) examination is carried out, its results are evaluated, and the index STV is determined. Foetal monitoring is carried out, during which the sum of areas of decelerates in the active phase of I period of labour is determined with the external CTG and STV index with direct CTG after 1 hour of monitoring. The obtained data are processed with the calculation of a prognostic index. On the basis of the obtained index value the development of acute foetus hypoxia is predicted.
EFFECT: method makes it possible to predict the development of acute foetus hypoxia in labour, which makes it possible to determine further obstetric tactics of labour management in due time.
The invention relates to medicine, namely to obstetrics and gynecology.
The most important task of modern obstetrics is to reduce perinatal morbidity and mortality. At present the problem of hypoxic States of the fetus during labor has not lost its relevance. In the structure of perinatal mortality hypoxia of the fetus and newborn is one of the leading places (30%). The frequency of fetal hypoxia is 4-6%, and in the structure of perinatal morbidity - 21-45%. Intrauterine hypoxia leads to damage of the Central nervous system, increases the frequency of somatic and infectious diseases, reduces the adaptation of the newborn in the early neonatal period, causing impaired psychomotor and intellectual development of children[1, 9, 10, 11, 12, 13, 14].
One of the leading causes of perinatal morbidity and mortality are hypoxic damage to the fetus during the intrapartum period. Hypoxic-ischemic lesion of the Central nervous system are one of the leading places in the structure of causes of high mortality and disability in infants. Thus, the proportion of hypoxic-ischemic lesion of the Central nervous system is 20 to 50% in the structure of perinatal mortality and up to 60-70% in the structure of causes of childhood disability [1, 2, 3]. Perinatal damaged�I the brain are responsible for the high mortality in the neonatal period, lead to the development of neurological complications and further define poor prognosis and quality of life of the child[4, 5, 8, 9, 10, 11, 12, 13, 14].
Reducing perinatal mortality in many respects it became possible thanks to the intensive monitoring of the fetus during pregnancy and childbirth with the help of modern research methods based on the analysis of cardiac activity [6, 7].
The level of technology
1. Prediction of abnormal fetus during labor is performed based on the analysis of a number of anamnestic characteristics: the presence of the mother of extragenital diseases, complications of pregnancy (preeclampsia, placental insufficiency, permanent threat of termination of pregnancy, multiple pregnancy, immunologic incompatibility of blood mother and the fetus, infection of the fetus) .
2. Assessment of fetal condition during labor is performed on the basis of ultrasonic vascular Doppler fetal, umbilical artery and uterine arteries .
3. Diagnosis of acute fetal hypoxia during labor is done using a blood sample from the skin of the fetal head to determine her pH .
Predicting the development of acute hypoxia of the fetus during childbirth based on the data intrapartum cardiotocography (CTG) . The disadvantage of this method is the difficulty �interpretatie monitor curves. A certain subjectivity in the analysis of cardiotocogram, completely depending on the experience and specialist skills, often leads to incorrect interpretation of monitor curves and therefore to incorrect tactical decisions that threaten the life and health of the child.
Summary of the invention
The aim of the invention is to develop a method of prognosis of acute intrapartum fetal hypoxia based on the analysis of different types of fetal monitoring to improve perinatal outcomes.
The method is as follows. The patient coming to give birth at full-term pregnancy in a generic office, carefully collect anamnestic data, specify the presence of chronic placental insufficiency (hfpn), oligohydramnios, the result CTG conducted the day before the birth, the rate of STV (short-term variation - variability of short pieces) according to the CTG held the day before the birth. When conducting intrapartum fetal monitoring in real time get the index of the sum of squares of decelerate the active phase of the first stage of labor when the outer CTG and indicator STV with direct CTG 1 hour fetal monitoring.
The method of mathematical analysis of the selected features was established prognostic index D and the corresponding formula:
X1 - oligohydramnios (presence - 1, no - 0);
X2 - hfpn, compensated form (available - 1, no - 0);
X3 - normal CTG birth (presence - 1, no - 0);
X4 - indicator STV birth (msec);
X5 is an indicator of the sum of squares of decelerate the active phase of the first stage of labor when the outer CTG 1 hour fetal monitoring (mm2);
X6 - indicator STV with direct CTG 1 hour fetal monitoring (msec);
If D>0, predict a high risk of acute fetal hypoxia during labor.
If D<0, predicts the birth of a healthy child.
The sensitivity of the decision rule 88%.
The specificity of 77%.
1. Maslennikov O. B., age 27, resident of the city of Yekaterinburg. He entered the ancestral branch for delivery in pregnancy 40-41 weeks. The analysis of anamnestic data. The patient history was revealed hfpn, compensated form and oligohydramnios by ultrasound (ultrasound). CTG is within normal limits, according to cardiotocography, held the day before the birth, the rate of STV was 9.7 msec. During intrapartum fetal monitoring indicator is the sum of the squares of decelerate the active phase of the first stage of labor when the outer CTG was 50 mm2indicator STV when you direct the CTG was 4.9 msec.The calculated prognostic index D according to the formula:
D>0, hence in mothers predict a high risk of acute fetal hypoxia during labor.
Medical card No. 1859. In childbirth were applied to vacuum extraction of the fetus. Born live, full-term baby weighing 3530 g, estimation on Apgar scale 6/7 scores, cord blood pH of 7.19. For 6 days was in intensive observation, diagnosed with ischemic-hypoxic lesions of the Central nervous system and spinal cord of 1-2 degrees.
2. Kozlova O. M., 28 years old, a resident of the city of Yekaterinburg. He entered the ancestral branch for delivery in pregnancy 39-40 weeks. The analysis of anamnestic data. The patient history was not revealed hfpn, compensated form and oligohydramnios by ultrasound. CTG is within normal limits, according to cardiotocography, held the day before the birth, the rate of STV was 9.3 msec. During intrapartum fetal monitoring indicator is the sum of the squares of decelerate the active phase of the first stage of labor when the outer CTG was 100 mm2indicator STV when you direct the CTG was 15.5 msec.
The calculated prognostic index D according to the formula:
D<0, and therefore, in mothers predicts the birth of a healthy child.
Medical �art No. 1932. Childbirth was conducted conservatively. Born live, full-term child weight of 2890 g, estimation on Apgar scale 7/8 points, pH of umbilical cord blood 7,27. Was discharged on the 5th day home from the hospital with a diagnosis of healthy.
Thus, the proposed method allows to predict acute intrapartum fetal hypoxia, which gives the opportunity to define future obstetric tactics of childbirth and to prevent the birth of children in serious condition.
Sources of information taken into account in the examination
1. Chigvintsev L. N. The definition of informativeness automated CTG to assess fetal condition during labor. Author. dis. MD - M. 2007. C. 3.
2. Ageeva M. I. Doppler study in obstetric practice. - M. 2000. P. 112.
3. Barashnev Y. I. Hypoxic encephalopathy: the hypothesis of the pathogenesis of cerebral disorders and the search for methods of drug therapy. The Russian Bulletin of Perinatology and Pediatrics; No. 1 2002. Pp. 6-9.
4. Zubarev, E. A. Integrated perinatal ultrasound assessment of cerebrovascular disorders in children the first year of life. Author. dis. M. D. M. 2006. P. 49.
5. Chernukha E. A. the Generic unit. - M. 2005. Pp. 138-153.
6. Demidov V. N., Sigizbaeva I. K., O. Y. Ogai, etc. Automated antenatal and intrapartum cardiotocography. Health and medical technologies. 2005; No. 9. P. 52-53.
7. IIR�low A., H. Thunell R. Clinical guidelines for asphyxia of the fetus and newborn. - SPb. 2001. P. 144.
8. Savelyeva G. M. Obstetrics. - M. 2000. P. 449.
9. Badalyan L. O. Protection of the developing brain is the most important task of perinatal medicine. Tashkent, 1989.
10. Barashnev Y. I. Akush. and gynecologist. 1993. No. 1. Pp. 14-18.
11. Barashnev Y. I., Y. V. Bessonova Obstetrics and gynecology. 1997. No. 2. Pp. 28-33.
12. Savelyeva G. M., L. G. Sichinava Russian Federation).. Vestn. Perinatology. and a pediatrician. 1995. No. 3. P. 19-23.
13. Yatsyk G. V. Preterm infants. - M. 1989.
14. Sautin S. B., The All-New V. V., Rozhkova N. Yu., Pokrovskaya S. A., Shestakova N. G. Risk factors and predict the development of perinatal hypoxic-ischemic lesions of the nervous system in newborns. ROS. Vestn. women. and a pediatrician. 2001. No. 1. P. 31-32.
15. Savelyeva G. M. Handbook of obstetrics, gynecology and Perinatology. - M. 2006. P. 126-127.
16. Makarov I. O., Yudina E. V. Cardiotocography in pregnancy and childbirth. - M. 2012. P. 52-53.
17. Orlov V. I. Cardiotocography and Doppler in modern obstetrics / V. I. Orlov, T. L. botcheva, V. F. Kuzin and others - M.: UNC RAS, 2007. - P. 113-114. P. 238-239.
18. Saling E. A new method for examination of the child during labor. Introduction, teaching and princi pies / E. Saling // Arch Gynakol. - 1962. - Vol.197. - P. 108.
Method predict the occurrence of acute fetal hypoxia during labor, characterized in that set in the history of the presence of placental insufficiency compensated�Oh form,
drought, the result set cardiotocography (CTG) and the indicator of STV, according to the CTG, held just before the birth, intrapartum fetal monitoring to determine the sum of squares of decelerate the active phase of the first stage of labor when the outer CTG and indicator STV with direct CTG 1 hour monitor and calculate the prognostic index D according to the formula:
X1 - oligohydramnios: presence 1, absence 0;
X2 - chronic fetoplacental insufficiency, compensated form: presence 1, absence 0;
X3 - normal CTG birth: presence 1, absence 0;
X4 - indicator STV before the birth, MS;
X5 is an indicator of the sum of squares of decelerate the active phase of the first stage of labor when the outer CTG 1 hour fetal monitoring, mm2;
X6 - indicator STV with direct CTG 1 hour fetal monitoring, MS;
and when D is more than 0 predict the occurrence of acute hypoxia of the fetus,
when D less than 0 is judged about the lack of risk of acute hypoxia of the fetus during labor.
SUBSTANCE: in the patients diagnosed with breast cancer and recommended to have a chemotherapeutic course, the heart rate is measured one week before the treatment according to electrocardiography after a 5-minute rest. If the measured heart rate is 70 beats per minute or more, ivabradine is prescribed in a daily dose of 10 mg. Electrocardiography is repeated after a 5-minute rest 4 weeks later. If the measured heart rate is 70 beats per minute or more, the dose is titration is made to 15 mg a day. If the measured follow-up heart rate is less than 70 beats per minute, the daily dose is kept at 10 mg. If the initial heart rate is less than 70 beats per minute, trimetasidine is prescribed in a daily dose of 70 mg for the whole period of treatment independent from the further heart rate measurement. All the patients take the preparation throughout the duration of 6 months.
EFFECT: method enables reducing the cardiotoxic action of the anthracycline chemopreparations in the patients with breast cancer.
3 ex, 4 dwg
SUBSTANCE: Holter ECG monitoring with recording total vegetative activity and measuring heart rate variability is conducted on the 21st day following ischemic stroke. Daily standard deviation of NN intervals (SDNN) is determined. If SDNN<71 ms, a high risk of cardiovascular complications following ischemic stroke is predicted.
EFFECT: method enables providing the informative and most accurate possible prediction of the risk of cardiovascular complications following ischemic stroke on the ground of daily standard deviation of NN intervals, which represent an independent predictive factor.
3 ex, 1 dwg, 2 tbl
SUBSTANCE: on the 21st day following an acute ischemic stroke, the patient has continuous Holter monitoring and ventricular extra systole recording. Observing frequent single ventricular extra systoles in number of more than ten an hour and grouped ventricular extra systoles enables predicting the high risk of cerebral complications following the ischemic stroke.
EFFECT: method enables predicting the high-grade risk of cerebral complications on the basis of ventricular extra systoles, which are an independent predictive factor of recurrent cerebral complications.
3 ex, 3 tbl
SUBSTANCE: estimation of the heart rate variability is realised by a method of 24-hour Holter monitoring of the 21st day from the moment of ischemic stroke development. After that, the power of a low-frequency spectrum is determined by means of spectral analysis and, if its value is lower than 117 ms2, a high risk of cardiac complications after the ischemic stroke is predicted.
EFFECT: method makes it possible to increase the accuracy of predicting a risk of development of cardiac complications after the ischemic stroke due to the identification of a certain LF value, an independent prognostic factor.
2 ex, 4 tbl, 2 dwg
SUBSTANCE: ECG is recorded. That is followed by a needle block of an ileocecal plexus with an anaesthetic solution in an amount of 60.0-80.0 ml; that is followed by recording another ECG after 60-90 min. The record is compared to the pre-block ECG record. If observing a positive dynamics in ECG results, ischemia caused by ileocecal-cardial inhibitory reflex is diagnosed, while no positive dynamics shows cardiogenic myocardial ischemia.
EFFECT: providing the more effective differential diagnostics of cardiogenic myocardial ischemia and ileocecal-cardial inhibitory reflex with underlying ileocecal patency.
SUBSTANCE: heart rate variability is assessed. The assessment procedure involves 24-hour Holter monitoring on the 21st day from the moment of the ischemic stroke occurred. And if observing brady-arrhythmias presented by degree 2-3 atrio-ventricular block or degree 2-3 sinoatrial block and sinus pauses of more than 2 sec long, a high risk of cardiovascular fatal complications following the ischemic stroke is predicted.
EFFECT: method provides the high informative and flexible prediction of the risk of cardiovascular fatal complications following the ischemic stroke in the patients with cerebrovascular, cardiac, endocrine comorbidities.
3 tbl, 3 ex
SUBSTANCE: electric cardio signal recorder in free motion activity comprises an amplifier (1), an analogue-to-digital converter with a multiplex switch (2) and series decomposition unit (3), second arithmetical-logical unit (4), an arithmetic unit (5), an increment code analyser (6), a switchover unit (7) and a digital modem (8), as well as a control unit (9), first (12) and second (10) memory units, an increment code counter (11). A second output of the second arithmetical-logical unit (4) is connected to a first input of a decomposition unit (3); an output of the second memory unit (10) is connected to a second output of the second arithmetical-logical unit (4); a second output of the increment code analyser (6) is connected to a first input of the first memory unit (12), while a third output - to a first input of the increment code counter (11), an output of which is connected to a second input of the first memory unit (12) an output of which us connected to an second input of the switchover unit (7); first, second, third, fourth, fifth and sixth outputs of the control unit (9) are connected respectively to a first input of the analogue-to-digital converter with the multiplex switch (2), a second input of the decomposition unit (3), an input of the second memory unit (10), a third input of the second arithmetical-logical unit (4), a second input of the increment code counter (11) and a third input of the switchover unit (7). The device also comprises an electrode break detector (13) and a heart critical state detector (14). The amplifier (1), the electrode break detector (13), the analogue-to-digital converter with the multiplex switch (2), the heart critical state detector (14) and the decomposition unit (3) are series connected. A seventh output of the control unit (9) is connected to a fourth input of the switchover unit (7); a second output (17) of the electrode break detector (13) is connected to a first input of the control unit (9), a second input of which is connected to a second output (24) of the heart critical state detector (14), and a second output of the second memory unit (10) is connected to a second input (22) of the heart critical state detector (14).
EFFECT: using the invention enables enhancement by detecting the electrode break and the heart critical state in free motion activity.
3 cl, 12 dwg
SUBSTANCE: invention relates to medicine, namely to paediatric cardiology and paediatric infectious diseases, and can be used for evaluation of indications for cardiometabolic therapy in case of infectious affection of myocardium in children. For this purpose quantitative evaluation of clinical, electrocardiographic, biochemical and echocardiographic indices is determined and realised. As clinical indices auscultative symptomatic: sonority of tones, presence of noises, parameters of arterial pressure are evaluated. As biochemical indices evaluated are: activity of cardiospeciphic enzymes: MB-fraction of creatine phosphokinase, α-hydroxybutyrate dehydrogenase, aspartic transaminase, alanine transaminase and cardiospecific troponin I protein. Echocardiographic examination is realised with application of Dopplerography for evaluation of diastolic ventricular function. Each of indices is evaluated by from 1 to 3 points. Points are summed up and obtained result is used to evaluate indications for cardiometabolic therapy. If the total sum is lower than 3 points, cardiometabolic therapy is not indicated. If the total sum is from 3 points to 7 point including, peroral introduction of cardiometabolic preparations is carried out. If the total sum is from 8 points and higher, parenteral introduction of cardiometabolic preparations is realised.
EFFECT: method provides possibility of determining presence of indications to administering cardiometabolic therapy objectively in minimal terms, including situations, when part of results of additional examination is absent because of some reasons, and of evaluating its efficiency in differential way.
1 tbl, 4 ex
SUBSTANCE: invention refers to medicine, namely to non-invasive techniques for qualitative-quantitative analysis of the cardiovascular functional state. A pulse signal and an electric heart signal are recorded for 2-3 minutes. The slow waves are recovered from two heart signals; slow-wave spectra are detected in two channels. The windowed Fourier transform is used to calculate spectral ratio powers of the slow waves of the heart signal in the second-order slow-term within the range of 0.01 to 0.05 Hz, in the first-order slow-term within the range of 0.05 to 0.15 Hz, in the respiratory component within the range of 0.15 to 0.5 Hz. The derived data are used to form six informative criteria X…X6. As the heart signal recorded in one of the channels, a heart rate is calculated and used as the seventh informative criterion. The generated seven-element vector of the informative criteria is supplied to an input of a trained neuron network, outputs of which correspond to the allocated classes of the cardiovascular diseases.
EFFECT: technique enables early diagnosing aiming at preventing the disease progression, thereby preventing an increase of the primary hypertension incidence by analysing two heart signals.
3 cl, 9 dwg, 2 ex
SUBSTANCE: recording ECG is followed by a perianal block with an anaesthetic solution in an amount of 10.0-15.0 ml. Then 60-90 min later ECG is recorded once again, and this recording is compared to the pre-block recording. If observing a positive dynamics of the ECG results, ischemia caused by the anorectal cardioinhibitory reflex is diagnosed. No positive dynamics observed enables diagnosing cardiogenic myocardial ischemia.
EFFECT: method makes it possible to perform the more accurate differential diagnosis of the above pathologies by following a specific procedure in case of pain syndrome in the given category of patients.
SUBSTANCE: method involves carrying out pulsating Doppler echocardiographic examination. Mean pressure is determined in pulmonary artery. Mean pressure in pulmonary artery being less than 13 mm of mercury column, no cardiac rhythm disorders risk is considered to take place. The value being greater than 13 mm of mercury column, complex cardiac rhythm disorder occurrence risk is considered to be the case.
EFFECT: accelerated noninvasive method.
FIELD: medicine; medical engineering.
SUBSTANCE: method involves selecting reference point in every cardiac cycle on TP-segment. Values of neighboring N=2n+1 reference points also belonging to TP-segment are recorded, n=1,2,…, beginning from the first reference point. Other reference points are set to zero. The central reference point value is left without changes in a group of 2n+1 member. Reference point values of each of n pairs of reference points symmetrically arranged relative to the central reference point are scaled relative to condition Uj=U0Kj, where U0 is the central reference point amplitude, Uj is amplitude of j-th reference point pair, j=1,2,…,n is the number of each reference point pair relative to the central reference point, Kj is the scaling coefficients determined from received signal suppression condition of the first n spectral zones in spectrum. The so formed electrocardiogram signal reference point groups sequence is let pass through lower frequency filter with isoline drift signal being obtained being produced on output. The signal is amplified and subtracted from the initial electrocardiogram signal that is preliminarily delayed for lower frequency filter delay time. Device has the first lower frequency filter, discretization unit and unit for selecting anchor reference points connected in series, as well as subtraction unit, unit for saving N reference points, scaling unit, the second lower frequency filter, amplifier and delay unit. Output of the unit for selecting anchor reference points is connected to the first input of memory unit the second input of which is connected to discretization unit output. Each of N memory unit outputs is connected to one of N inputs of scaling units. Scaling unit output is connected to the second lower frequency filter input which output is connected to amplifier input. Amplifier output is connected to the first input of subtraction unit, the second output of subtraction unit is connected to delay unit output. Its input is connected to output of the first lower frequency filter. Subtraction unit output is the device output.
EFFECT: reliable removal of isoline drift.
2 cl, 8 dwg
FIELD: medicine; cardiology.
SUBSTANCE: device has amplifier, analog-to-digital converter provided with multiplexer, arithmetic unit, memory unit, digital modem, increment code analyzer, increment codes number counter, switching unit and control unit as well as second memory unit, digital filtration unit and decimation unit. Electrocardiogram signal is registered within frequency-time area. Increase in volume of diagnostic data is provided due to time localization of spectral components of electrocardiogram signal.
EFFECT: widened operational capabilities; improved precision of diagnosing; higher efficiency of treatment.
FIELD: medicine; radio electronics.
SUBSTANCE: device for taking cardiogram has set of electrodes, cardiologic unit, analog-to-digital converter, cardio signal preliminary treatment unit, computer, lower frequency filter, differentiator, functional converter and controlled filter. Power function calculation units are not included. Preliminary continuous filtering of cardio signal entering the computer is provided.
EFFECT: simplified design; improved precision of measurement.
FIELD: medical engineering.
SUBSTANCE: device has electrodes, input amplifier, unit for protecting against error influence when applying medical electric instruments, low frequency filter, signal analysis unit, unit for eliminating isoline drift and electric power supply units.
EFFECT: high accuracy in plotting rhythmograms; improved instruments manipulation safety.
SUBSTANCE: method involves modeling real three-dimensional patient heart image based on electrocardiogram and photoroentgenogram data and determining basic functional values of its myohemodynamics.
EFFECT: high accuracy and reliability of the method.
2 cl, 5 dwg
SUBSTANCE: method involves recording cardiac biopotentials with vector electrocardiograph, processing and visualizing signal with graphical plane integral cardiac electric vector projections (vector electrocardiograms) being built and analyzed. Shape, QRS-loop value and vector orientation-recording process are determined. Analysis is based on planar vector electrocardiograms in horizontal, frontal and sagittal planes and in spatial 3-D-form. Vector loop direction is studied in X-,Y-,Z-axis projections, values, dynamics and localization are evaluated in resulting integral cardiac electric vector delta-vector space. To do it, QRS-loop is divided into four segments, one of which characterizes excitation in middle part of axial partition surface, the second one is related to excitation in lower ventricular septum one-third with cardiac apex being involved and the third and the fourth one is related to excitation in basal parts of the left and right heart ventricles. Delta-vector existence and its magnitude are determined from changes in loop segment localization when compared to reference values.
EFFECT: improved data quality usable in planning surgical treatment.
FIELD: medical radio electronics.
SUBSTANCE: device can be used for testing cardio-vascular system of patient. Differential vector-cardiograph has high frequency oscillator, common electrode, unit for reading electrocardiogram and radio cardiogram provided with amplification channels and filtration channels, multiplexer, microprocessor unit with common bus, analog-to-digital converter, keyboard, mouse and indication unit. Device provides higher precision of measurements due to usage of electric component heart activity and truth of diagnostics due to ability of representation of results of testing in form of variety of vector-cardiograms in real time-scale.
EFFECT: improved precision.
FIELD: medicine, cardiology, arhythmology, functional diagnostics.
SUBSTANCE: one should register electrocardiogram in esophagus, apply an electrode in a site where the maximum signal amplitude is registered, increase the signal 5-fold, not less to be filtered in the range of 0.5-40 Hz to be registered at the rate of 100 mm/sec, not less. The time for intra-atrial process should be measured from the beginning of ascending part of the first positive wave of pre-P-tooth up to the top of the second adhesion of P-tooth; the time for inter-atrial process should be measured from the site of crossing a descending part of the first positive wave and the onset of obliquely ascending pre-P-interval up to crossing this interval with the point of abrupt increase of the first phase of P-tooth. The innovation provides more means for noninvasive evaluation of intra- and inter-atrial stimulation process.
EFFECT: higher accuracy of evaluation.
FIELD: medicine, cardiology.
SUBSTANCE: one should register a standard electrocardiogram (ECG) and measure the duration of a "P"-wave. Moreover, it is necessary to conduct daily ECG monitoring to calculate single, paired and group atrial extrasystoles. Then one should calculate diagnostic coefficient DC by the following formula: DC=DC1+DC2+DC3+DC4, DC1 =-8.8 at duration of "P"-wave below 106 msec, 9.3 at duration of "P"-wave above 116 msec, -3.5 at duration of "P"-wave ranged 106-116 msec. DC2=-1.9 at the absence of group atrial extrasystoles during a day, 8.3 -at daily quantity of group atrial extrasystoles being above 4, 2.5 - at daily quantity of group atrial extrasystoles ranged 1-4. DC3=-2.9 at daily quantity of paired atrial extrasystoles being below 3, 8.1 - at daily quantity of paired extrasystoles being above 35, -1.4 - at daily quantity of paired atrial extrasystoles ranged 3-35. DC4=-5.1 at daily quantity of single atrial extrasystoles being below 15, 4.3 - at daily quantity of single atrial extrasystoles being above 150, -1.0 - at daily quantity of single atrial extrasystoles ranged 15-150, if DC is above or equal to 13 one should diagnose high risk for the development of paroxysmal atrial fibrillation, in case if DC is below or equal -13 it is possible to diagnose no risk for the development of paroxysmal atrial fibrillation, and if DC is above -13 and below 13 - the diagnosis is not established.
EFFECT: higher sensitivity of diagnostics.