The clinical condition and functional performance of the heart in patients with persistent atrial fibrillation after electrical cardioversion.
Atrial fibrillation (AF) - one of the most common cardiac arrhythmia, which leads to increased mortality, increased risk of stroke, heart failure, worsening of quality of life. The aim of the study was to examine the clinical condition and hemodynamic performance of the heart in patients with non-valvular persistent AF before and 6 months after the restoration of sinus rhythm by electrical cardioversion (ECV). According to the study, it was found that the major diseases against which persistent AF is diagnosed: hypertension (87.7%), obesity (60.5%) and a combination of these diseases (33%). Hold of sinus rhythm within 6 months after ECV is accompanied by a significant improvement in clinical condition: the number of patients with significant dyspnea (scale MRC=3) has decreased (12% of patients versus 34% at the time of the ECV) (p <0.01), dyspnea (scale MRC=1) - 22% of the patients (p <0.05). Heart failure III FC remained only in 10% of patients versus 28% t the time of the ECV (p <0.05). Long-term preservation of sinus rhythm improved atrial function: ejection fraction LA increased by 25.8% (p <0.01), RA by 18% (p <0.05), decreased volume of indexed parameters in systole (LA - 21.3 %, RA - 26.4%) and diastolic (LA - 12.4%, RA - 21.6%) (p <0.001). Contractile function of the left ventricle improved: ejection fraction increased by 14.3%, SV - 13.7% (p <0.001), diastolic volume decreased by 20.7% (p <0.01). Despite optimal medical therapy, clinical status and cardiac hemodynamic parameters in patients with recurrent AF have not improved.
Dzjak GV, Zharіnov OJ. [Atrial fibrillation]. Kiїv: Chetverta hvilja. 2011;192. Ukrainian. 2. Kovalenko VM, Sichov OS. [Recommendation of the working group of arrhythmias of Ukrainian As-sociation of Cardiology «Diagnosis and treatment of atrial fibrillation»]. Kiїv, 2015;167. Ukrainian. 3. Kovalenko VM et al. [Guidelines of Cardiology]. Kiev: Morion. 2008;1424. Russian. 4. January CT et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. Circulation 2014;130(23):e199-e267. 5. Huxley RR, et al. Absolute and attributable risks of atrial fibrillation in relation to optimal and borderline risk factors: the Atherosclerosis Risk in Communities (ARIC) study. Circulation 2011;123:1501-8. 6. Wanahita MD, Messerli FH et al. Atrial fibril¬lation and obesity—results of a meta-analysis. Am Heart J 2008;155:310-5. 7. Gillis AM, et al. Canadian Cardiovascular Society Atrial Fibrillation Guidelines 2010: Rate and Rhythm Management. Canad J Card. 2011;27:47-59. 8. Cutugno CL. Atrial Fibrillation: Updated Mana-ge¬ment Guidelines and Nursing Implication. AJN 2015;115:26-38. 9. European Heart Rhythm Association, et al. Guide¬lines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J. 2010;31(19):2369-429. 10. Naccarelli GV, et al. Increasing prevalence of atrial fibrillation and flutter in the United States. Am J Cardiol 2009;104(11):1534-9. 11. Tedrow UB, Conen D, Ridker PM et al. The long- and short-term impact of elevated body mass index on the risk of new atrial fibrillation: the WHS (Women’s Health Study). J Am Coll Cardiol. 2010; 5:2319-27.
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