Options for antiarrhythmic therapy after surgical treatment of the atrial fibrillation
| Autor: | G. N Abramova, V. A Karnakhin, Vladlen V. Bazylev, E. V Nemchenko |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
lcsh:Diseases of the circulatory (Cardiovascular) system
medicine.medical_specialty lcsh:RC648-665 business.industry surgical treatment Significant difference Left atrium Atrial fibrillation Retrospective cohort study medicine.disease lcsh:Diseases of the endocrine glands. Clinical endocrinology medicine.anatomical_structure lcsh:RC666-701 Bisoprolol Heart failure Internal medicine medicine Cardiology atrial fibrillation antiarrythmic therapy Sinus rhythm Surgical treatment business cox-maze iv medicine.drug |
| Zdroj: | КардиоСоматика, Vol 6, Iss 4, Pp 30-34 (2015) |
| ISSN: | 2658-5707 2221-7185 |
| Popis: | Aim. To assess the afficiency of using different shcemes of the antiarrythmic therapy (AAT) after the surgical treatment of the atrial fibrillation (AF).Material and methods. This retrospective study included 279 patients: 141 (49%) females and 168 (51%) males, aged 59±7.9 years who had got Сox-Maze IV procedure at Federal cardiovascular center (Penza). 27 patient (9.7%) had the paroxysmal AF, 252 (90.3%) - the persistent one. The AF’s duration was 36 months (from 1 to 180). The size of the left atrium was average 52.4±8.4 mm (from 40 to 82 mm). The medium functional class (FC) of heart failure (HF) (NYHA) was 2.8±0.4: II FC-63 (22.6%), III FC - 213 (76.3%), IV FC - 3 (1.1%). There were 3 groups of patients:1 group had 57 patients who had got amiodaron over 6 months; 2 group - 126 patients who had got b-blocker (b-B) (bisoprolol) long monotherapy; 3 group - 96 patients who had got amiodaron during 3-6 months then had got bisoprolol long therapy. All patiens got Cox-Maze IV procedure.Results. Remote results assessed after 6 months-3 years period after the operation. In all groups the number of patients with I and II FC HF increased; there was significant difference at 2 group (p1-2=0.01; p2-3=0.01; p1- 3=0.73). And there were more patients with sinus rhythm at 2 group than at 3 group significantly. The freedom from AF at 1 group was 77%±0.89, at 2 group - 68%±0.98, at 3 group - 85%±0.95 with the significant difference between 2 and 3 groups (р1-2=0.61; p1-3=0.13; p2-3=0.01).Conclusions. AAT by amiodaron during 3-6 months and then by beta-blocker (bisoprolol) longly after Cox-Maze IV procedure allows to keep sinus rhythm to 85% patiens at the distant period of time and comparing with the b-blocker-monotherapy allows to keep sinus rhythm more effectively. The difference of efficiency by long amiodaron-monotherapy and amiodaron-therapy during 3-6 months is not got statistical significant after Cox-Maze IV procedure. |
| Databáze: | OpenAIRE |
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