The aim of the work is to study the type, frequency and features of the course of rhythm disturbances in patients with chronic heart failure (CHF), depending on the etiology, including in the presence of type 2 diabetes mellitus (DM).

Material and methods. In-depth clinical observations were carried out with the analysis of indicators obtained by electro- and echocardiography, performing a 6-minute walking test, and monitoring the ECG by Holter, in 197 patients with the presence of registered cardiac arrhythmias. Men predominated (56-61%), the average age was 61.3 ± 0.63 years. CHF was determined in 74 patients (group 1), in 80 — a combination of CHF mainly of the II functional class according to NYHA and type 2 diabetes (group 2), in 43 - type 2 diabetes (group 3) according to the criteria American Diabetes Association (2011). The groups were comparable in gender, age, severity and presence of complications. The exclusion criteria are acute forms of coronary heart disease, decompensation of CHF and DM, the presence of CHF according to the National Recommendations of the IOC and the OSS (2009).

Results. In patients with CHF, the highest frequency of ventricular arrhythmias was found — about half (43.2%; p < 0.02) of patients, atrial fibrillation — in every tenth (10.8%). In combination with CHF and type 2 diabetes, combined cardiac arrhythmias prevailed (41.2%; p < 0.01): supraventricular and ventricular, including such hemodynamically and prognostically significant arrhythmias as atrial fibrillation and ventricular arrhythmias of high gradations. Supraventricular cardiac arrhythmias have been reported mainly in patients with DM Type 2 (62.8%).

Conclusion. A high frequency of hemodynamically and prognostically unfavorable arrhythmias is diagnosed mainly in patients with CHF in combination with type 2 diabetes, which is due to both aggravation of myocardial insufficiency and pathogenetic factors associated with diabetes (dysglycemia, cardiovascular autonomic neuropathy, diabetic nephropathy).

Heart rhythm disorder; chronic heart failure; type 2 diabetes mellitus.

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