Анализ предикторов развития синдрома слабости синусового узла после открытого хирургического лечения фибрилляции предсердий
Анализ предикторов развития синдрома слабости синусового узла после открытого хирургического лечения фибрилляции предсердий
Карнахин В.А., Базылев В.В., Воеводин А.Б., Сластин Я.С. Анализ предикторов развития синдрома слабости синусового узла после открытого хирургического лечения фибрилляции предсердий. CardioСоматика. 2020; 11 (4): 20–24. DOI: 10.26442/22217185.2020.4.200571
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Аннотация
Цель. Выявить и проанализировать предикторы развития синдрома слабости синусового узла (СССУ) у больных с фибрилляцией предсердий.
Материал и методы. В исследование включены 847 пациентов c пароксизмальной (121) и постоянной (726) формой фибрилляции предсердий, перенесших процедуру Cox-Maze IV c коррекцией клапанной и/или коронарной патологии в условиях искусственного кровообращения. В качестве независимых предикторов рассмотрены: объем оперативного вмешательства, клинические, лабораторные и эхокардиографические параметры.
Результаты. Имплантация постоянного электрокардиостимулятора (ЭКС) на госпитальном этапе потребовалась 37 (4,3%) из 847 пациентов. Ни у одного из этих пациентов не отмечали показаний к имплантации ЭКС до вмешательства. Показания для имплантации кардиостимулятора: СССУ – у 30 (3,5%), брадиаритмии – у 6 (0,7%); синдром Фредерика – у 1 (0,11%) пациента. СССУ – наиболее частая причина установки ЭКС. Анализ нейронных сетей показал, что индекс массы тела, время искусственного кровообращения, время искусственной вентиляции легких, а также возраст пациента являются независимыми предикторами развития данного состояния.
Заключение. Ожирение, время искусственного кровообращения, время искусственной вентиляции легких, а также возраст пациента являются независимыми наиболее значимыми предикторами развития СССУ.
Ключевые слова: фибрилляция предсердий, синдром слабости синусового узла, электрокардиостимулятор, операция Cox-Maze IV.
Material and methods. We include 847 patients with paroxysmal (121) and permanent (726) form of atrial fibrillation in our research. Patients underwent the Cox-Maze IV procedure with correction of valvular and/or coronary pathology in the conditions of artificial blood circulation. The volume of surgical intervention, clinical, laboratory and echocardiographic parameters were considered as independent predictors.
Results. Permanent pacemaker implantation at the hospital stage required 37 (4.3%) from all 847 patients. None of these patients had indications for permanent pacemaker implantation before the intervention. Indications for pacemaker implantation: sick sinus syndrome – in 30 (3.5%), bradiarrhythmia – in 6 (0.7%); Frederick's syndrome – in 1 (0.11%) patient. Sinus node weakness syndrome is the most common reason for installing permanent pacemaker. Analysis of neural networks showed that body mass index, time of cardiopulmonary bypass, time of mechanical ventilation, and the age of the patient are independent predictors of the development of this condition.
Conclusion. Obesity, time of cardiopulmonary bypass, time of mechanical ventilation, and age of the patient are the independent and most significant predictors of the development of sick sinus syndrome.
Key words: atrial fibrillation, sick sinus syndrome, pacemaker, Cox-Maze IV surgery.
Материал и методы. В исследование включены 847 пациентов c пароксизмальной (121) и постоянной (726) формой фибрилляции предсердий, перенесших процедуру Cox-Maze IV c коррекцией клапанной и/или коронарной патологии в условиях искусственного кровообращения. В качестве независимых предикторов рассмотрены: объем оперативного вмешательства, клинические, лабораторные и эхокардиографические параметры.
Результаты. Имплантация постоянного электрокардиостимулятора (ЭКС) на госпитальном этапе потребовалась 37 (4,3%) из 847 пациентов. Ни у одного из этих пациентов не отмечали показаний к имплантации ЭКС до вмешательства. Показания для имплантации кардиостимулятора: СССУ – у 30 (3,5%), брадиаритмии – у 6 (0,7%); синдром Фредерика – у 1 (0,11%) пациента. СССУ – наиболее частая причина установки ЭКС. Анализ нейронных сетей показал, что индекс массы тела, время искусственного кровообращения, время искусственной вентиляции легких, а также возраст пациента являются независимыми предикторами развития данного состояния.
Заключение. Ожирение, время искусственного кровообращения, время искусственной вентиляции легких, а также возраст пациента являются независимыми наиболее значимыми предикторами развития СССУ.
Ключевые слова: фибрилляция предсердий, синдром слабости синусового узла, электрокардиостимулятор, операция Cox-Maze IV.
________________________________________________
Material and methods. We include 847 patients with paroxysmal (121) and permanent (726) form of atrial fibrillation in our research. Patients underwent the Cox-Maze IV procedure with correction of valvular and/or coronary pathology in the conditions of artificial blood circulation. The volume of surgical intervention, clinical, laboratory and echocardiographic parameters were considered as independent predictors.
Results. Permanent pacemaker implantation at the hospital stage required 37 (4.3%) from all 847 patients. None of these patients had indications for permanent pacemaker implantation before the intervention. Indications for pacemaker implantation: sick sinus syndrome – in 30 (3.5%), bradiarrhythmia – in 6 (0.7%); Frederick's syndrome – in 1 (0.11%) patient. Sinus node weakness syndrome is the most common reason for installing permanent pacemaker. Analysis of neural networks showed that body mass index, time of cardiopulmonary bypass, time of mechanical ventilation, and the age of the patient are independent predictors of the development of this condition.
Conclusion. Obesity, time of cardiopulmonary bypass, time of mechanical ventilation, and age of the patient are the independent and most significant predictors of the development of sick sinus syndrome.
Key words: atrial fibrillation, sick sinus syndrome, pacemaker, Cox-Maze IV surgery.
Список литературы
1. Ad N, Barnett SD, Haan CK et al. Does preoperative atrial fibrillation increase the risk for mortality and morbidity after coronary artery bypass grafting? Thorac Cardiovasc Surg 2009; 137: 901–6.
2. Maesen B et al. Post-operative atrial fibrillation: a maze of mechanisms. Europace 2011; eur208.
3. Funk M et al. Incidence, timing, symptoms, and risk factors for atrial fibrillation after cardiac surgery. Am J Critl Care 2003; 12 (5): 424–33.
4. Базылев В.В., Немченко Е.В., Сластин Я.С., Карнахин В.А. Взаимосвязь SYNTAX score и фибрилляции предсердий в раннем послеоперационном периоде у пациентов после изолированного коронарного шунтирования. CardioСоматика. 2018; 9 (1): 5–9.
[Bazylev V.V., Nemchenko E.V., Slastin Ya.S., Karnakhin V.A. Relationship between SYNTAX score and atrial fibrillation in the early postoperative period in patients after isolated coronary artery bypass grafting. Cardiosomatics. 2018; 9 (1): 5–9 (in Russian).]
5. Peretto G et al. Postoperative arrhythmias after cardiac surgery: incidence, risk factors, and therapeutic management. Cardiol Res Pract 2014; 2014.
6. Fuster V et al. ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines developed in partnership with the European Society of Cardiology and in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society.
J Am Coll Cardiol 2011; 57: e101–98.
7. Bulent G et al. 2016. ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J 2016.
8. Calkins H et al. 2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design. Heart Rhythm 2012; 9: 632–96.e21.
9. Barnett SD et al. Surgical ablation as treatment for the elimination of atrial fibrillation: a meta-analysis. J Thorac Cardiovasc Surg 2006; 131: 1029–35.
10. Кушаковский М.С. Аритмии сердца: Руководство для врачей. СПб.: Гиппократ, 1992.
[Kushakovsky M.S. Cardiac arrhythmias: A guide for doctors. Saint Petersburg: Hippocrates, 1992 (in Russian).]
11. Кушаковский М.С. Фибрилляция и трепетание предсердий. Лечение фармакологическими и электрофизиологическими (нехирургическими) методами. Вестн. аритмологии. 1998; 7: 56–64.
[Kushakovskii M.S. Fibrilliatsiia i trepetanie predserdii. Lechenie farmakologicheskimi i elektrofiziologicheskimi (nekhirurgicheskimi) metodami. Vestn. aritmologii. 1998; 7: 56–64 (in Russian).]
12. Pasic M et al. Transient sinus node dysfunction after the Cox-maze III procedure in patients with organic heart disease and chronic fixed atrial fibrillation. J Am Coll Cardiol 1998; 32: 1040–7.
13. Pasic M et al. The Cox-maze procedure: parallel normalization of sinus node dysfunction, improvement of atrial function, and recovery of the cardiac autonomic nervous system. J Thorac Cardiovasc Surg 1999; 118: 287–96.
14. Cox JL et al. Modification of the maze procedure for atrial flutter and atrial fibrillation, I: rationale and surgical results. J Thorac Cardiovasc Surg 1995; 110: 473–84.
15. Cox JL et al. Current status of the Maze procedure for the treatment of atrial fibrillation. Semin Thorac Cardiovasc Surg 2000; 12: 15–9.
16. Cheng DC et al. Surgical ablation for atrial fibrillation in cardiac surgery: a meta-analysis and systematic review. Innovations (Phila) 2010; 5: 84–96.
17. Blomström-Lundqvist C et al. A randomized double-blind study of epicardial left atrial cryoablation for permanent atrial fibrillation in patients undergoing mitral valve surgery: the SWEDish Multicentre Atrial Fibrillation study. Eur Heart J 2007; 28: 2902–08.
18. Ad N, Henry L, Hunt S, Holmes SD. Do we increase the operative risk by adding the Cox Maze III procedure to aortic valve replacement and coronary artery bypass surgery? J Thorac Cardiovasc Surg 2012; 143: 936–44.
19. Mohr FW et al. Curative treatment of atrial fibrillation with intraoperative radiofrequency ablation: short-term and midterm results. J Thorac Cardiovasc Surg 2002; 123: 919–27.
20. Moten SC, Rodriguez E, Cook RC. New ablation techniques for atrial fibrillation and the minimally invasive cryo-maze procedure in patients with lone atrial fibrillation. Heart Lung Circ 2007; 16: S88–93.
21. Yamane T, Shah DC, Jais P et al. Electrogram polarity reversal as an additional indicator of breakthroughs from the left atrium to the pulmonary veins. J Am Coll Cardiol 2002; 39: 1337–44.
22. Yamane T, Date T, Kanzaki Y et al. Segmental pulmonary vein antrum isolation using the “large-size” lasso catheter in patients with atrial fibrillation. Circ J 2007; 71: 753–60.
23. Pasic M, Musci M, Siniawski H et al. Transient sinus node dysfunction after the Coxmaze III procedure in patients with organic heart disease and chronic fixed atrial fibrillation. J Am Coll Cardiol 1998; 32: 1040–7.
2. Maesen B et al. Post-operative atrial fibrillation: a maze of mechanisms. Europace 2011; eur208.
3. Funk M et al. Incidence, timing, symptoms, and risk factors for atrial fibrillation after cardiac surgery. Am J Critl Care 2003; 12 (5): 424–33.
4. Bazylev V.V., Nemchenko E.V., Slastin Ya.S., Karnakhin V.A. Relationship between SYNTAX score and atrial fibrillation in the early postoperative period in patients after isolated coronary artery bypass grafting. Cardiosomatics. 2018; 9 (1): 5–9 (in Russian).
5. Peretto G et al. Postoperative arrhythmias after cardiac surgery: incidence, risk factors, and therapeutic management. Cardiol Res Pract 2014; 2014.
6. Fuster V et al. ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines developed in partnership with the European Society of Cardiology and in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. J Am Coll Cardiol 2011; 57: e101–98.
7. Bulent G et al. 2016. ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J 2016.
8. Calkins H et al. 2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design. Heart Rhythm 2012; 9: 632–96.e21.
9. Barnett SD et al. Surgical ablation as treatment for the elimination of atrial fibrillation: a meta-analysis. J Thorac Cardiovasc Surg 2006; 131: 1029–35.
10. Kushakovsky M.S. Cardiac arrhythmias: A guide for doctors. Saint Petersburg: Hippocrates, 1992 (in Russian).
11. Kushakovskii M.S. Fibrilliatsiia i trepetanie predserdii. Lechenie farmakologicheskimi i elektrofiziologicheskimi (nekhirurgicheskimi) metodami. Vestn. aritmologii. 1998; 7: 56–64 (in Russian).
12. Pasic M et al. Transient sinus node dysfunction after the Cox-maze III procedure in patients with organic heart disease and chronic fixed atrial fibrillation. J Am Coll Cardiol 1998; 32: 1040–7.
13. Pasic M et al. The Cox-maze procedure: parallel normalization of sinus node dysfunction, improvement of atrial function, and recovery of the cardiac autonomic nervous system. J Thorac Cardiovasc Surg 1999; 118: 287–96.
14. Cox JL et al. Modification of the maze procedure for atrial flutter and atrial fibrillation, I: rationale and surgical results. J Thorac Cardiovasc Surg 1995; 110: 473–84.
15. Cox JL et al. Current status of the Maze procedure for the treatment of atrial fibrillation. Semin Thorac Cardiovasc Surg 2000; 12: 15–9.
16. Cheng DC et al. Surgical ablation for atrial fibrillation in cardiac surgery: a meta-analysis and systematic review. Innovations (Phila) 2010; 5: 84–96.
17. Blomström-Lundqvist C et al. A randomized double-blind study of epicardial left atrial cryoablation for permanent atrial fibrillation in patients undergoing mitral valve surgery: the SWEDish Multicentre Atrial Fibrillation study. Eur Heart J 2007; 28: 2902–08.
18. Ad N, Henry L, Hunt S, Holmes SD. Do we increase the operative risk by adding the Cox Maze III procedure to aortic valve replacement and coronary artery bypass surgery? J Thorac Cardiovasc Surg 2012; 143: 936–44.
19. Mohr FW et al. Curative treatment of atrial fibrillation with intraoperative radiofrequency ablation: short-term and midterm results. J Thorac Cardiovasc Surg 2002; 123: 919–27.
20. Moten SC, Rodriguez E, Cook RC. New ablation techniques for atrial fibrillation and the minimally invasive cryo-maze procedure in patients with lone atrial fibrillation. Heart Lung Circ 2007; 16: S88–93.
21. Yamane T, Shah DC, Jais P et al. Electrogram polarity reversal as an additional indicator of breakthroughs from the left atrium to the pulmonary veins. J Am Coll Cardiol 2002; 39: 1337–44.
22. Yamane T, Date T, Kanzaki Y et al. Segmental pulmonary vein antrum isolation using the “large-size” lasso catheter in patients with atrial fibrillation. Circ J 2007; 71: 753–60.
23. Pasic M, Musci M, Siniawski H et al. Transient sinus node dysfunction after the Coxmaze III procedure in patients with organic heart disease and chronic fixed atrial fibrillation. J Am Coll Cardiol 1998; 32: 1040–7.
2. Maesen B et al. Post-operative atrial fibrillation: a maze of mechanisms. Europace 2011; eur208.
3. Funk M et al. Incidence, timing, symptoms, and risk factors for atrial fibrillation after cardiac surgery. Am J Critl Care 2003; 12 (5): 424–33.
4. Базылев В.В., Немченко Е.В., Сластин Я.С., Карнахин В.А. Взаимосвязь SYNTAX score и фибрилляции предсердий в раннем послеоперационном периоде у пациентов после изолированного коронарного шунтирования. CardioСоматика. 2018; 9 (1): 5–9.
[Bazylev V.V., Nemchenko E.V., Slastin Ya.S., Karnakhin V.A. Relationship between SYNTAX score and atrial fibrillation in the early postoperative period in patients after isolated coronary artery bypass grafting. Cardiosomatics. 2018; 9 (1): 5–9 (in Russian).]
5. Peretto G et al. Postoperative arrhythmias after cardiac surgery: incidence, risk factors, and therapeutic management. Cardiol Res Pract 2014; 2014.
6. Fuster V et al. ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines developed in partnership with the European Society of Cardiology and in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society.
J Am Coll Cardiol 2011; 57: e101–98.
7. Bulent G et al. 2016. ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J 2016.
8. Calkins H et al. 2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design. Heart Rhythm 2012; 9: 632–96.e21.
9. Barnett SD et al. Surgical ablation as treatment for the elimination of atrial fibrillation: a meta-analysis. J Thorac Cardiovasc Surg 2006; 131: 1029–35.
10. Кушаковский М.С. Аритмии сердца: Руководство для врачей. СПб.: Гиппократ, 1992.
[Kushakovsky M.S. Cardiac arrhythmias: A guide for doctors. Saint Petersburg: Hippocrates, 1992 (in Russian).]
11. Кушаковский М.С. Фибрилляция и трепетание предсердий. Лечение фармакологическими и электрофизиологическими (нехирургическими) методами. Вестн. аритмологии. 1998; 7: 56–64.
[Kushakovskii M.S. Fibrilliatsiia i trepetanie predserdii. Lechenie farmakologicheskimi i elektrofiziologicheskimi (nekhirurgicheskimi) metodami. Vestn. aritmologii. 1998; 7: 56–64 (in Russian).]
12. Pasic M et al. Transient sinus node dysfunction after the Cox-maze III procedure in patients with organic heart disease and chronic fixed atrial fibrillation. J Am Coll Cardiol 1998; 32: 1040–7.
13. Pasic M et al. The Cox-maze procedure: parallel normalization of sinus node dysfunction, improvement of atrial function, and recovery of the cardiac autonomic nervous system. J Thorac Cardiovasc Surg 1999; 118: 287–96.
14. Cox JL et al. Modification of the maze procedure for atrial flutter and atrial fibrillation, I: rationale and surgical results. J Thorac Cardiovasc Surg 1995; 110: 473–84.
15. Cox JL et al. Current status of the Maze procedure for the treatment of atrial fibrillation. Semin Thorac Cardiovasc Surg 2000; 12: 15–9.
16. Cheng DC et al. Surgical ablation for atrial fibrillation in cardiac surgery: a meta-analysis and systematic review. Innovations (Phila) 2010; 5: 84–96.
17. Blomström-Lundqvist C et al. A randomized double-blind study of epicardial left atrial cryoablation for permanent atrial fibrillation in patients undergoing mitral valve surgery: the SWEDish Multicentre Atrial Fibrillation study. Eur Heart J 2007; 28: 2902–08.
18. Ad N, Henry L, Hunt S, Holmes SD. Do we increase the operative risk by adding the Cox Maze III procedure to aortic valve replacement and coronary artery bypass surgery? J Thorac Cardiovasc Surg 2012; 143: 936–44.
19. Mohr FW et al. Curative treatment of atrial fibrillation with intraoperative radiofrequency ablation: short-term and midterm results. J Thorac Cardiovasc Surg 2002; 123: 919–27.
20. Moten SC, Rodriguez E, Cook RC. New ablation techniques for atrial fibrillation and the minimally invasive cryo-maze procedure in patients with lone atrial fibrillation. Heart Lung Circ 2007; 16: S88–93.
21. Yamane T, Shah DC, Jais P et al. Electrogram polarity reversal as an additional indicator of breakthroughs from the left atrium to the pulmonary veins. J Am Coll Cardiol 2002; 39: 1337–44.
22. Yamane T, Date T, Kanzaki Y et al. Segmental pulmonary vein antrum isolation using the “large-size” lasso catheter in patients with atrial fibrillation. Circ J 2007; 71: 753–60.
23. Pasic M, Musci M, Siniawski H et al. Transient sinus node dysfunction after the Coxmaze III procedure in patients with organic heart disease and chronic fixed atrial fibrillation. J Am Coll Cardiol 1998; 32: 1040–7.
________________________________________________
2. Maesen B et al. Post-operative atrial fibrillation: a maze of mechanisms. Europace 2011; eur208.
3. Funk M et al. Incidence, timing, symptoms, and risk factors for atrial fibrillation after cardiac surgery. Am J Critl Care 2003; 12 (5): 424–33.
4. Bazylev V.V., Nemchenko E.V., Slastin Ya.S., Karnakhin V.A. Relationship between SYNTAX score and atrial fibrillation in the early postoperative period in patients after isolated coronary artery bypass grafting. Cardiosomatics. 2018; 9 (1): 5–9 (in Russian).
5. Peretto G et al. Postoperative arrhythmias after cardiac surgery: incidence, risk factors, and therapeutic management. Cardiol Res Pract 2014; 2014.
6. Fuster V et al. ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines developed in partnership with the European Society of Cardiology and in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. J Am Coll Cardiol 2011; 57: e101–98.
7. Bulent G et al. 2016. ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J 2016.
8. Calkins H et al. 2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design. Heart Rhythm 2012; 9: 632–96.e21.
9. Barnett SD et al. Surgical ablation as treatment for the elimination of atrial fibrillation: a meta-analysis. J Thorac Cardiovasc Surg 2006; 131: 1029–35.
10. Kushakovsky M.S. Cardiac arrhythmias: A guide for doctors. Saint Petersburg: Hippocrates, 1992 (in Russian).
11. Kushakovskii M.S. Fibrilliatsiia i trepetanie predserdii. Lechenie farmakologicheskimi i elektrofiziologicheskimi (nekhirurgicheskimi) metodami. Vestn. aritmologii. 1998; 7: 56–64 (in Russian).
12. Pasic M et al. Transient sinus node dysfunction after the Cox-maze III procedure in patients with organic heart disease and chronic fixed atrial fibrillation. J Am Coll Cardiol 1998; 32: 1040–7.
13. Pasic M et al. The Cox-maze procedure: parallel normalization of sinus node dysfunction, improvement of atrial function, and recovery of the cardiac autonomic nervous system. J Thorac Cardiovasc Surg 1999; 118: 287–96.
14. Cox JL et al. Modification of the maze procedure for atrial flutter and atrial fibrillation, I: rationale and surgical results. J Thorac Cardiovasc Surg 1995; 110: 473–84.
15. Cox JL et al. Current status of the Maze procedure for the treatment of atrial fibrillation. Semin Thorac Cardiovasc Surg 2000; 12: 15–9.
16. Cheng DC et al. Surgical ablation for atrial fibrillation in cardiac surgery: a meta-analysis and systematic review. Innovations (Phila) 2010; 5: 84–96.
17. Blomström-Lundqvist C et al. A randomized double-blind study of epicardial left atrial cryoablation for permanent atrial fibrillation in patients undergoing mitral valve surgery: the SWEDish Multicentre Atrial Fibrillation study. Eur Heart J 2007; 28: 2902–08.
18. Ad N, Henry L, Hunt S, Holmes SD. Do we increase the operative risk by adding the Cox Maze III procedure to aortic valve replacement and coronary artery bypass surgery? J Thorac Cardiovasc Surg 2012; 143: 936–44.
19. Mohr FW et al. Curative treatment of atrial fibrillation with intraoperative radiofrequency ablation: short-term and midterm results. J Thorac Cardiovasc Surg 2002; 123: 919–27.
20. Moten SC, Rodriguez E, Cook RC. New ablation techniques for atrial fibrillation and the minimally invasive cryo-maze procedure in patients with lone atrial fibrillation. Heart Lung Circ 2007; 16: S88–93.
21. Yamane T, Shah DC, Jais P et al. Electrogram polarity reversal as an additional indicator of breakthroughs from the left atrium to the pulmonary veins. J Am Coll Cardiol 2002; 39: 1337–44.
22. Yamane T, Date T, Kanzaki Y et al. Segmental pulmonary vein antrum isolation using the “large-size” lasso catheter in patients with atrial fibrillation. Circ J 2007; 71: 753–60.
23. Pasic M, Musci M, Siniawski H et al. Transient sinus node dysfunction after the Coxmaze III procedure in patients with organic heart disease and chronic fixed atrial fibrillation. J Am Coll Cardiol 1998; 32: 1040–7.
Авторы
В.А. Карнахин*, В.В. Базылев, А.Б. Воеводин, Я.С. Сластин
ФГБУ «Федеральный центр сердечно-сосудистой хирургии» Минздрава России, Пенза, Россия
*cardio-penza@yandex.ru
Federal Center of Cardiovascular Surgery, Penza, Russia
*cardio-penza@yandex.ru
ФГБУ «Федеральный центр сердечно-сосудистой хирургии» Минздрава России, Пенза, Россия
*cardio-penza@yandex.ru
________________________________________________
Federal Center of Cardiovascular Surgery, Penza, Russia
*cardio-penza@yandex.ru
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