Лечение фибрилляции предсердий у коморбидных пациентов пожилого и старческого возраста
Лечение фибрилляции предсердий у коморбидных пациентов пожилого и старческого возраста
Дощицин В.Л., Федорова М.Х. Лечение фибрилляции предсердий у коморбидных пациентов пожилого и старческого возраста. Consilium Medicum. 2018; 20 (12): 47–54. DOI: 10.26442/20751753.2018.12.180156
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V.L.Doschitsin, M.H.Fedorova. Treatment of atrial fibrillation in comorbid patients of the senior age. Consilium Medicum. 2018; 20 (12): 47–54. DOI: 10.26442/20751753.2018.12.180156
Лечение фибрилляции предсердий у коморбидных пациентов пожилого и старческого возраста
Дощицин В.Л., Федорова М.Х. Лечение фибрилляции предсердий у коморбидных пациентов пожилого и старческого возраста. Consilium Medicum. 2018; 20 (12): 47–54. DOI: 10.26442/20751753.2018.12.180156
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V.L.Doschitsin, M.H.Fedorova. Treatment of atrial fibrillation in comorbid patients of the senior age. Consilium Medicum. 2018; 20 (12): 47–54. DOI: 10.26442/20751753.2018.12.180156
Фибрилляция предсердий – одна из самых распространенных и клинически значимых аритмий сердца. Большинство пациентов с фибрилляцией предсердий, нуждающихся в лечении, – лица пожилого и старческого возраста, имеющие коморбидную патологию. В обзорной статье представлены данные о выборе стратегии и тактики ведения таких больных, подборе антиаритмической медикаментозной терапии, направленной на восстановление и удержание синусового ритма или на урежение ритма желудочков. Рассмотрены возможности использования радиочастотной аблации предсердий и последующего приема антиаритмических препаратов с учетом существующих международных рекомендаций.
Atrial fibrillation is the most common and clinically significant cardiac arrhythmias. Most patients with atrial fibrillation who need treatment are elderly persons with a comorbid pathology. The review article presents data on the choice of strategy and tactics for managing such patients, the selection of antiarrhythmic drug therapy aimed at restoring and maintaining the sinus rhythm, or at decreasing the ventricular rhythm frequensy. The possibilities of using radiofrequency ablation of atria and the subsequent administration of antiarrhythmic drugs are considered taking into account the existing international recommendations.
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71. Miwa Y, Minamiguchi Н, Bhandari АК et al. Cannom Amiodarone reduces the amount of ablation during catheter ablation for persistent atrial fibrillation. J Europace 2014; 16: 1007–14.
72. Catheter Ablation vs. Antiarrhythmic Drug Treatment of Persistent Atrial Fibrillation: A Multicenter, Randomized, Controlled Trial (SARA Study). 2013.
73. Тарасов А.В., Давтян К.В., Махинова М.М. Результаты применения пропафенона в раннем послеоперационном периоде катетерной радиочастотной изоляции устьев легочных вен для предупреждения ранних предсердных тахиаритмий. CardioСоматика. 2015; 6 (2): 47–52. / Tarasov A.V., Davtian K.V., Makhinova M.M. Results of propafenone use in early postoperative period after pulmonary veinscatheter radiofrequency isolation for prevention of early atrial tachyarrhythmias. Cardiosomatics. 2015; 6 (2): 47–52. [in Russian]
74. Gu J, Liu X, Tan H et al. Extensive antiarrhythmic drugs after catheter ablation of persistent atrial fibrillation. Acta Cardiol 2012; 67 (4): 407–14.
75. Verma A, Kilicaslan F, Pisano E et al. Response of atrial fibrillation to pulmonary vein antrum isolation is directly related to resumption and delay of pulmonary vein conduction. Circulation 2005; 112 (5): 627–35.
76. Berkowitsch A, Greiss H, Vukajlovic D et al. Usefulness of atrial fibrillation burden as a predictor for success of pulmonary vein isolation. Pacing Clin Electrophysiol 2005; 28 (12): 1292–301.
77. Baman TS, Gupta SK, Billakanty SR et al. Time to cardioversion of recurrent atrial arrhythmias after catheter ablation of atrial fibrillation and long-term clinical outcome. J Cardiovasc Electrophysiol 2009; 20 (12): 1321–5.
78. Choi JI, Pak HN, Park JS et al. Clinical significance of early reccurrences of atrial tachycardia after atrial fibrillation. J Cardiovasc Electrophysiol 2010; 1331–7.
79. Pappone C, Vicedomini G, Augello G et al. Radiofrequency catheter ablation and antiarrhythmic drug therapy: a prospective, randomized, 4-year follow-up trial: the APAF study Circ Arrhythm Electrophysiol 2011; 4 (6): 808–14.
80. Nielsen JC, Johannessen А, Raatikainen P et al. Radiofrequency Ablation as Initial Therapy in Paroxysmal Atrial Fibrillation. N Engl J Med 2012; 367: 1587–95.
81. Hummel J, Michaud G, Hoyt R et al. Phased RF ablation in persistent atrial fibrillation. Heart Rhythm 2014; 11: 202–9.
82. Reynolds MR, Walczak J, White SA et al. Improvements in symptoms and quality of life in patients with paroxysmal atrial fibrillation treated with radiofrequency catheter ablation versus antiarrhythmic drugs. Irc Cardiovasc Qual Outcomes 2010; 3 (6): 615–23.
83. Morillo CA, Verma A, Connolly SJ et al. RAAFT-2 Investigators. Radiofrequency ablation vs antiarrhythmic drugs as first-line treatment of paroxysmal atrial fibrillation (RAAFT-2): a randomized trial: JAMA 2014; 311 (22): 2337.
84. Moreno J, Zamorano JL. The CABANA trial. Eur Heart J 2014; 35 (29): 1908–9.
85. www.cabanatrial.org/the-cabana-research-trial, clinicaltrials.gov
________________________________________________
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70. Themistoclakis S, Schweikert RA, Saliba WI et al. Clinical predictors and relationship between early and late atrial tachyarrhythmias after pulmonary vein antrum isolation. Heart Rhythm 2008; 5 (5): 679–85.
71. Miwa Y, Minamiguchi Н, Bhandari АК et al. Cannom Amiodarone reduces the amount of ablation during catheter ablation for persistent atrial fibrillation. J Europace 2014; 16: 1007–14.
72. Catheter Ablation vs. Antiarrhythmic Drug Treatment of Persistent Atrial Fibrillation: A Multicenter, Randomized, Controlled Trial (SARA Study). 2013.
73. Tarasov A.V., Davtian K.V., Makhinova M.M. Results of propafenone use in early postoperative period after pulmonary veinscatheter radiofrequency isolation for prevention of early atrial tachyarrhythmias. Cardiosomatics. 2015; 6 (2): 47–52. [in Russian]
74. Gu J, Liu X, Tan H et al. Extensive antiarrhythmic drugs after catheter ablation of persistent atrial fibrillation. Acta Cardiol 2012; 67 (4): 407–14.
75. Verma A, Kilicaslan F, Pisano E et al. Response of atrial fibrillation to pulmonary vein antrum isolation is directly related to resumption and delay of pulmonary vein conduction. Circulation 2005; 112 (5): 627–35.
76. Berkowitsch A, Greiss H, Vukajlovic D et al. Usefulness of atrial fibrillation burden as a predictor for success of pulmonary vein isolation. Pacing Clin Electrophysiol 2005; 28 (12): 1292–301.
77. Baman TS, Gupta SK, Billakanty SR et al. Time to cardioversion of recurrent atrial arrhythmias after catheter ablation of atrial fibrillation and long-term clinical outcome. J Cardiovasc Electrophysiol 2009; 20 (12): 1321–5.
78. Choi JI, Pak HN, Park JS et al. Clinical significance of early reccurrences of atrial tachycardia after atrial fibrillation. J Cardiovasc Electrophysiol 2010; 1331–7.
79. Pappone C, Vicedomini G, Augello G et al. Radiofrequency catheter ablation and antiarrhythmic drug therapy: a prospective, randomized, 4-year follow-up trial: the APAF study Circ Arrhythm Electrophysiol 2011; 4 (6): 808–14.
80. Nielsen JC, Johannessen А, Raatikainen P et al. Radiofrequency Ablation as Initial Therapy in Paroxysmal Atrial Fibrillation. N Engl J Med 2012; 367: 1587–95.
81. Hummel J, Michaud G, Hoyt R et al. Phased RF ablation in persistent atrial fibrillation. Heart Rhythm 2014; 11: 202–9.
82. Reynolds MR, Walczak J, White SA et al. Improvements in symptoms and quality of life in patients with paroxysmal atrial fibrillation treated with radiofrequency catheter ablation versus antiarrhythmic drugs. Irc Cardiovasc Qual Outcomes 2010; 3 (6): 615–23.
83. Morillo CA, Verma A, Connolly SJ et al. RAAFT-2 Investigators. Radiofrequency ablation vs antiarrhythmic drugs as first-line treatment of paroxysmal atrial fibrillation (RAAFT-2): a randomized trial: JAMA 2014; 311 (22): 2337.
84. Moreno J, Zamorano JL. The CABANA trial. Eur Heart J 2014; 35 (29): 1908–9.
85. www.cabanatrial.org/the-cabana-research-trial, clinicaltrials.gov
Авторы
В.Л.Дощицин*, М.Х.Федорова
ФГБУ ДПО «Центральная государственная медицинская академия» Управления делами Президента РФ. 121359, Россия, Москва, ул. Маршала Тимошенко, д. 19
*vlad.dos@mail.r*
________________________________________________
V.L.Doschitsin*, M.H.Fedorova
Central State Medical Academy of the Administrative Department of the President of the Russian Federation. 121359, Russian Federation, Moscow, ul. Marshala Timoshenko, d. 19
*vlad.dos@mail.ru