10 research outputs found
The functional condition of left atrium during the endovascular treatment of atrial fibrillation
The atrial fibrillation causes structural and functional changes of atriums. In this case, the remodeling of left atrium increases the risk of AF. One of the treatment strategy is catheter isolation of the pulmonary veins. However, the effectiveness of these operations does not exceed 70% in most of the cases that may be due to remodeling of left atrium. In this regard, the assessment of the condition of left atrium is actual for the optimization of treatment tactics and improvement of effectiveness rate.Π€ΠΈΠ±ΡΠΈΠ»Π»ΡΡΠΈΡ ΠΏΡΠ΅Π΄ΡΠ΅ΡΠ΄ΠΈΠΉ Π²ΡΠ·ΡΠ²Π°Π΅Ρ ΡΡΡΡΠΊΡΡΡΠ½ΡΠ΅ ΠΈ ΡΡΠ½ΠΊΡΠΈΠΎΠ½Π°Π»ΡΠ½ΡΠ΅ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΏΡΠ΅Π΄ΡΠ΅ΡΠ΄ΠΈΠΉ. ΠΡΠΈ ΡΡΠΎΠΌ ΡΠ΅ΠΌΠΎΠ΄Π΅Π»ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ Π»Π΅Π²ΠΎΠ³ΠΎ ΠΏΡΠ΅Π΄ΡΠ΅ΡΠ΄ΠΈΡ ΡΠ²Π΅Π»ΠΈΡΠΈΠ²Π°Π΅Ρ ΡΠΈΡΠΊ Π²ΠΎΠ·Π½ΠΈΠΊΠ½ΠΎΠ²Π΅Π½ΠΈΡ Π€Π. ΠΠ΄Π½Π° ΠΈΠ· ΡΡΡΠ°ΡΠ΅Π³ΠΈΠΉ Π»Π΅ΡΠ΅Π½ΠΈΡ - ΠΊΠ°ΡΠ΅ΡΠ΅ΡΠ½Π°Ρ ΠΈΠ·ΠΎΠ»ΡΡΠΈΡ Π»Π΅Π³ΠΎΡΠ½ΡΡ
Π²Π΅Π½. ΠΠ΄Π½Π°ΠΊΠΎ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ Π΄Π°Π½Π½ΡΡ
ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΉ Π² Π±ΠΎΠ»ΡΡΠΈΠ½ΡΡΠ²Π΅ ΡΠ»ΡΡΠ°Π΅Π² Π½Π΅ ΠΏΡΠ΅Π²ΡΡΠ°Π΅Ρ 70%, ΡΡΠΎ ΠΌΠΎΠΆΠ΅Ρ Π±ΡΡΡ ΠΎΠ±ΡΡΠ»ΠΎΠ²Π»Π΅Π½ΠΎ, Π² ΡΠΎΠΌ ΡΠΈΡΠ»Π΅, ΡΠ΅ΠΌΠΎΠ΄Π΅Π»ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ Π»Π΅Π²ΠΎΠ³ΠΎ ΠΏΡΠ΅Π΄ΡΠ΅ΡΠ΄ΠΈΡ. Π ΡΠ²ΡΠ·ΠΈ Ρ ΡΡΠΈΠΌ, Π°ΠΊΡΡΠ°Π»ΡΠ½Π° ΠΎΡΠ΅Π½ΠΊΠ° ΡΠΎΡΡΠΎΡΠ½ΠΈΡ Π»Π΅Π²ΠΎΠ³ΠΎ ΠΏΡΠ΅Π΄ΡΠ΅ΡΠ΄ΠΈΡ Π΄Π»Ρ ΠΎΠΏΡΠΈΠΌΠΈΠ·Π°ΡΠΈΠΈ ΡΠ°ΠΊΡΠΈΠΊΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΈ ΡΠ»ΡΡΡΠ΅Π½ΠΈΡ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ
CRYOBALLOON ABLATION IN RUSSIAN SITES OF INTERVENTIONAL ATRIAL FIBRILLATION MANAGEMENT TREATMENT: RESULTS OF THE FIRST NATIONWIDE SURVEY
Aim. The results of cryoballoon ablation (CBA) are known from the studies performed in the experienced centers of catheter treatment of atrial fibrillation (AF). The current study presents the results of CBA in real practice in centers with various experienceMaterial and methods. Among 62 Russian sites performing catheter treatment of AF, in 15 the CBA methods were in use to isolate pulmonary veins, in the years 2012-2014. Centers staff were surveyed for the detailed description of all performed CBA till 10.2014. The questionnaire included 74 lines about the centers experience, patients properties and ablation procedures, management of patients and complications. At the second step the questionnaire was used about complications.Results. Thirteen centers provided full data on all patients with CBA (457 procedures; 94% for paroxysmal AF; >95% CBAs in Russia). Six centers were marked as highly experienced for CBA for AF (mean 414,2Β±339,4 ablations for AF per year), and 7 β with lesser experience (33,2Β±34,3 ablations for AF per year). Ten centers provided the results of 6/12 month observation, and 11 centers β detalization of the complications data. there were no statistically significant differences in arrhythmia absence in patients from both types of centers (61,9Β±10,0 versus 61,3Β±30,4%). Serious complications developed in 1,5% of patients (4 tamponades, 2 strokes and 1 diaphragmal nerve palsy) and were similarly spread among more and less experienced centers (1,4% vs. 2%, p>0,05). Minor adverse events (vascular, transient diaphragm nerve palsy, transient hemoptysis) were found in 37 (8%) patients and were more common in more experienced (teaching) centers. Overall frequency of adverse events and of vascular events was higher in females than males (12% and 4,9% vs. 6% and 0%, resp.; p<0,05).Conclusion. In the real clinical practice CBA is performed with acceptable efficacy and moderate frequency of adverse events development. In less experienced centers of catheter treatment of AF the prevalence of serious adverse events does not differ from less experienced. Women develop vascular complications more often
ΠΠ΅Π»ΡΠ΄ΠΎΡΠΊΠΎΠ²Π°Ρ ΡΠΊΡΡΡΠ°ΡΠΈΡΡΠΎΠ»ΠΈΡ Ρ Π΄Π΅ΡΠ΅ΠΉ
The article presents updated data on the problem of premature ventricular contractions in children based on the clinical guidelines of the Russian Society of Cardiology and the Union of Pediatricians of Russia for the diagnosis, treatment and management of pediatric patients with premature ventricular contraction. The issues of diagnosis and treatment based on the principles of evidence-based medicine as well as important aspects of prevention of exacerbations and follow-up have been clarified in detail. The criteria for assessing the quality of care for patients with premature ventricular contractions have been presented.CONFLICT OF INTEREST. Not declared.Π ΡΡΠ°ΡΡΠ΅ ΠΈΠ·Π»ΠΎΠΆΠ΅Π½Ρ ΠΎΠ±Π½ΠΎΠ²Π»Π΅Π½Π½ΡΠ΅ Π΄Π°Π½Π½ΡΠ΅ ΠΎ ΠΏΡΠΎΠ±Π»Π΅ΠΌΠ΅ ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠΊΠΎΠ²ΡΡ
ΡΠΊΡΡΡΠ°ΡΠΈΡΡΠΎΠ»ΠΈΠΉ Ρ Π΄Π΅ΡΠ΅ΠΉ, ΠΎΡΠ½ΠΎΠ²Π°Π½Π½ΡΠ΅ Π½Π° ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΡΡ
ΠΡΡΠΎΡΠΈΠ°ΡΠΈΠΈ Π΄Π΅ΡΡΠΊΠΈΡ
ΠΊΠ°ΡΠ΄ΠΈΠΎΠ»ΠΎΠ³ΠΎΠ² Π ΠΎΡΡΠΈΠΈ ΠΈ Π‘ΠΎΡΠ·Π° ΠΏΠ΅Π΄ΠΈΠ°ΡΡΠΎΠ² Π ΠΎΡΡΠΈΠΈ ΠΏΠΎ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅, Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΈ Π²Π΅Π΄Π΅Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π΄Π΅ΡΡΠΊΠΎΠ³ΠΎ Π²ΠΎΠ·ΡΠ°ΡΡΠ° Ρ ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠΊΠΎΠ²ΠΎΠΉ ΡΠΊΡΡΡΠ°ΡΠΈΡΡΠΎΠ»ΠΈΠ΅ΠΉ. ΠΠΎΠ΄ΡΠΎΠ±Π½ΠΎ ΠΎΡΠ²Π΅ΡΠ΅Π½Ρ Π²ΠΎΠΏΡΠΎΡΡ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ, Π»Π΅ΡΠ΅Π½ΠΈΡ, ΠΎΡΠ½ΠΎΠ²Π°Π½Π½ΡΠ΅ Π½Π° ΠΏΡΠΈΠ½ΡΠΈΠΏΠ°Ρ
Π΄ΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΡΠ½ΠΎΠΉ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½Ρ, Π° ΡΠ°ΠΊΠΆΠ΅ Π²Π°ΠΆΠ½ΡΠ΅ Π°ΡΠΏΠ΅ΠΊΡΡ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠΈ ΠΎΠ±ΠΎΡΡΡΠ΅Π½ΠΈΠΉ Π±ΠΎΠ»Π΅Π·Π½ΠΈ ΠΈ Π΄ΠΈΡΠΏΠ°Π½ΡΠ΅ΡΠ½ΠΎΠ³ΠΎ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ. ΠΡΠΎΠ±ΡΠ°ΠΆΠ΅Π½Ρ ΠΊΡΠΈΡΠ΅ΡΠΈΠΈ ΠΎΡΠ΅Π½ΠΊΠΈ ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌ Ρ ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠΊΠΎΠ²ΡΠΌΠΈ ΡΠΊΡΡΡΠ°ΡΠΈΡΡΠΎΠ»ΠΈΡΠΌΠΈ.ΠΡΠ±Π»ΠΈΠΊΠ°ΡΠΈΡ ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΎΠ±Π½ΠΎΠ²Π»Π΅Π½Π½ΡΠΌ Π²Π°ΡΠΈΠ°Π½ΡΠΎΠΌ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΉ ΠΡΡΠΎΡΠΈΠ°ΡΠΈΠΈ Π΄Π΅ΡΡΠΊΠΈΡ
ΠΊΠ°ΡΠ΄ΠΈΠΎΠ»ΠΎΠ³ΠΎΠ² Π ΠΎΡΡΠΈΠΈ ΠΈ Π‘ΠΎΡΠ·Π° ΠΏΠ΅Π΄ΠΈΠ°ΡΡΠΎΠ² Π ΠΎΡΡΠΈΠΈ ΠΏΠΎ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅, Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΈ Π²Π΅Π΄Π΅Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π΄Π΅ΡΡΠΊΠΎΠ³ΠΎ Π²ΠΎΠ·ΡΠ°ΡΡΠ° Ρ ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠΊΠΎΠ²ΠΎΠΉ ΡΠΊΡΡΡΠ°ΡΠΈΡΡΠΎΠ»ΠΈΠ΅ΠΉ, ΠΎΠΏΡΠ±Π»ΠΈΠΊΠΎΠ²Π°Π½Π½ΡΡ
Π½Π° ΡΠ°ΠΉΡΠ΅ https://medi.ru/klinicheskie-rekomendatsii/zheludochkovaya-ekstrasistoliya-u-detej_14366/ΠΠ²ΡΠΎΡΡ ΠΏΠΎΠ΄ΡΠ²Π΅ΡΠΆΠ΄Π°ΡΡ ΠΎΡΡΡΡΡΡΠ²ΠΈΠ΅ ΠΊΠΎΠ½ΡΠ»ΠΈΠΊΡΠ° ΠΈΠ½ΡΠ΅ΡΠ΅ΡΠΎΠ², ΠΊΠΎΡΠΎΡΡΠΉ Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎ ΠΎΠ±Π½Π°ΡΠΎΠ΄ΠΎΠ²Π°ΡΡ
Ventricular arrhythmias. Ventricular tachycardias and sudden cardiac death. 2020 Clinical guidelines
Russian Society of Cardiology (RSC).With the participation of Russian Scientific Society of Clinical Electrophysiology, Arrhythmology and Cardiac Pacing, Russian Association of Pediatric Cardiologists, Society for Holter Monitoring and Noninvasive Electrocardiology.Approved by the Scientific and Practical Council of the Russian Ministry of Health
Syncope in children with hypertrophic cardiomyopathy
Seventy children aged 7 to 17 years with hypertrophic cardiomyopathy (HCM) were examined; among them there were 11 syncope patients and 5 presyncope patients. The screening program included standard electrocardiography (ECG), Doppler echocardiogra-phy, 24-hour Holter ECG monitoring, and an incremental exercise testing (Bruce treadmill test). The markers of myocardial electrical instability were determined. In the children with HCM, syncope was established to be heterogeneous; it had an arrhythmogenic origin and, in most cases, occurred in the presence of tachyarrhythmia (44%) or bradyarrythmia (25%); its vasovagal genesis was probable in one third of the examinees. The children with syncope were typified by the asymmetric, obstructive form of HCM, at the same tone there was most commonly left ventricular hypertrophy concurrent with left atrial enlargement. 24-hour Holter monitoring showed that bradycardia was prevalent in the patients, 3 patients were found to have more than 2-second cardiac rhythm pauses caused by second-degree atrioventricular block in 1 case or by sick sinus syndrome in 2. Nonsustained ventricular tachycardia was noted in two patients. The children with syncope were typified by the signs of myocardial electrical instability as a reduction in the early phase of heart rate turbulence and by impaired QT/RR interval adaptation as hyperadaptation. The paper presents the developed management tactics for children with syncope and indications for the implantation of a cardioverter defibrillator, a pacemaker, or an ECG loop recorder
An algorithm for topical electrocardiographic diagnosis of ventricular arrhythmias in children
To develop a topical diagnostic algorithm, the authors analyzed surface ECG in 243 children, including 139 boys, with ventricularΒ arrhythmia. The childrenβs age was 5 to 17 years (mean 13.4Β±3.1 years). The found ECG features were compared with the resultsΒ of endocardial mapping and radiofrequency ablation. Based on the most informative criteria, the authors developed an algorithm forΒ the ECG diagnosis of ventricular arrhythmias in children, which could locate the arrhythmia focus prior to interventional treatment.Β The most informative electrocardiographic characteristics for the topical diagnosis of ventricular arrhythmias in children were theΒ morphology of the QRS complex in lead V1 and its duration in lead V2. The morphology of the QRS complex in lead I, its durationΒ in lead II, the amplitude of the R wave in lead III, and the ratio of R/S wave amplitudes in lead V3 were proposed to be used as additionalΒ characteristics. The algorithm for the ECG diagnosis of ventricular arrhythmias in children makes it possible to assume theΒ localization of the arrhythmogenic focus with an accuracy of 90% and to carry out a directed endocardial mapping, which reduces theΒ duration of radiofrequency ablation and the radiological burden sustained by the child and the staff
Premature Ventricular Contraction in Children
The article presents updated data on the problem of premature ventricular contractions in children based on the clinical guidelines of the Russian Society of Cardiology and the Union of Pediatricians of Russia for the diagnosis, treatment and management of pediatric patients with premature ventricular contraction. The issues of diagnosis and treatment based on the principles of evidence-based medicine as well as important aspects of prevention of exacerbations and follow-up have been clarified in detail. The criteria for assessing the quality of care for patients with premature ventricular contractions have been presented.CONFLICT OF INTEREST. Not declared
Outcomes of Cryoballoon Ablation in High-and Low-Volume Atrial Fibrillation Ablation Centres: A Russian Pilot Survey
properly cited. Purpose. The results of cryoballoon ablation (CBA) procedure have been mainly derived from studies conducted in experienced atrial fibrillation (AF) ablation centres. Here, we report on CBA efficacy and complications resulting from real practice of this procedure at both high-and low-volume centres. Methods. Among 62 Russian centres performing AF ablation, 15 (24%) used CBA technology for pulmonary vein isolation. The centres were asked to provide a detailed description of all CBA procedures performed and complications, if encountered. Results. Thirteen sites completed interviews on all CBAs in their centres (>95% of CBAs in Russia). Six sites were high-volume AF ablation (>100 AF cases/year) centres, and 7 were low-volume AF ablation. There was no statistical difference in arrhythmia-free rates between high-and low-volume centres (64.6 versus 60.8% at 6 months). Major complications developed in 1.5% of patients and were equally distributed between high-and low-volume centres. Minor procedurerelated events were encountered in 8% of patients and were more prevalent in high-volume centres. Total event and vascular access site event rates were higher in women than in men. Conclusions. CBA has an acceptable efficacy profile in real practice. In less experienced AF ablation centres, the major complication rate is equal to that in high-volume centres
Outcomes of Cryoballoon Ablation in High- and Low-Volume Atrial Fibrillation Ablation Centres: A Russian Pilot Survey
Purpose. The results of cryoballoon ablation (CBA) procedure have been mainly derived from studies conducted in experienced atrial fibrillation (AF) ablation centres. Here, we report on CBA efficacy and complications resulting from real practice of this procedure at both high- and low-volume centres. Methods. Among 62 Russian centres performing AF ablation, 15 (24%) used CBA technology for pulmonary vein isolation. The centres were asked to provide a detailed description of all CBA procedures performed and complications, if encountered. Results. Thirteen sites completed interviews on all CBAs in their centres (>95% of CBAs in Russia). Six sites were high-volume AF ablation (>100 AF cases/year) centres, and 7 were low-volume AF ablation. There was no statistical difference in arrhythmia-free rates between high- and low-volume centres (64.6 versus 60.8% at 6 months). Major complications developed in 1.5% of patients and were equally distributed between high- and low-volume centres. Minor procedure-related events were encountered in 8% of patients and were more prevalent in high-volume centres. Total event and vascular access site event rates were higher in women than in men. Conclusions. CBA has an acceptable efficacy profile in real practice. In less experienced AF ablation centres, the major complication rate is equal to that in high-volume centres