Aim.to evaluate the effectiveness of cardiac contractility modulation (MSS) in patients with chronic heart failure (CHF) and atrial fibrillation (AF). Materials and methods.The following studies were performed in 40 patients with CHF and AF before implantation of the MSS device and after 2 and 6 months of follow-up: 12-channel ECG, transthoracic EchoCG, 6-minute walk test, determination of the level of Pro-natriuretic N-terminal peptide (NT-proBNP), daily ECG monitoring, and a questionnaire based on the Minnesota quality of life questionnaire for patients with CHF (MHFLQ). All patients received long-term optimal drug therapy for CHF before surgery. Results.The results obtained indicate a statistically significant positive effect of the use of MSS in patients with CHF and AF on LV FV, the functional class of CHF, and levels of NT-proBNP regardless of the etiology of CHF. Conclusion.The use of MSS may be promising for the treatment of heart failure in patients with CHF and AF.
Aim To evaluate a possibility of using radiofrequency catheter ablation guided by intracardiac echocardiography (ICE), its efficacy and safety for treatment of ventricular tachycardia (VT) of various etiology.Material and methods Catheter intervention was performed for 20 enrolled patients with symptomatic VT. Ablation procedures were guided by a 3D electroanatomical mapping system and ICE.Results Mean duration of the procedure was 201.2±62.5 min. The procedure was successful (non-inducibility of VT) in 100% of cases. None of the patients had postoperative complications.Conclusion Ablation of VT arrhythmogenic substrate guided by 3D electroanatomical navigational mapping and ICE without X-ray is feasible and safe.
Objective: To evaluate the effectiveness and safety of subcutaneous implantable cardioverter-defibrillators versus transvenous implantable cardioverter-defibrillators during 6-month follow-up.Methods: The prospective research successively included 95 patients with indications for primary prevention of sudden cardiac death. The patients were divided into 2 groups: group 1 — 52 patients with subcutaneous implantable cardioverter-defibrillators, group 2 — 43 patients with transvenous implantable cardioverter-defibrillators. The patients were followed up for 6 months. All episodes of applied shock therapy, complications, patients changes in the condition and quality of life were analyzed.Results: The groups were initially comparable in terms of gender, age, etiology of the disease, and severity of the condition. Male patients prevailed (subcutaneous implantable cardioverter-defibrillators — 90.3%, transvenous implantable cardioverter-defibrillators — 93.0%), the mean age for subcutaneous devices was 56 [49;62] years and 60 [54;65] years for transvenous implantable cardioverter-defibrillators. All patients had chronic heart failure. The median LV EF for subcutaneous implantable cardioverter-defibrillator and transvenous implantable cardioverter-defibrillator was 29% [26;32] and 30% [27;32], respectively, EDV — 220 mL [187;278] and 202 mL [186;248], ESV — 151 mL [126;188] and 145 mL [122;184]. The number of complications recorded during the 6-month follow-up was slightly higher in patients who were implanted with subcutaneous implantable cardioverter-defibrillator (subcutaneous implantable cardioverter-defibrillators — 7.6%, transvenous implantable cardioverter-defibrillators — 2.3%, p = 0.249). The incidence of inadequate shocks in the groups was comparable (7.7% for subcutaneous implantable cardioverter-defibrillators, 6.9% for transvenous implantable cardioverter-defibrillators, p = 0.882). The percentage of using adequate shock therapy was higher in the transvenous implantable cardioverter-defibrillator group, 18.6% versus 5.7% in the subcutaneous implantable cardioverter-defibrillator group (p = 0.051). Implantation of the devices (both subcutaneous and transvenous) improved quality of life according to the results of questionnaires (Minnesota and EQ-5D questionnaires) before implantation and after 6 months of follow-up (p < 0.001 in both groups).Conclusion: This research demonstrates comparable results for the effectiveness and safety of subcutaneous implantable cardioverter-defibrillators compared with transvenous implantable cardioverter-defibrillators in patients with the need for primary prevention of sudden cardiac death within 6 months. Received 6 October 2022. Revised 28 February 2023. Accepted 1 March 2023. Funding: The study did not have sponsorship. Conflict of interest: The authors declare no conflict of interest. Contribution of the authorsConception and study design: A.V. Vereshchagina, T.M. Uskach, O.V. SapelnikovData collection and analysis: A.V. Vereshchagina, V.A. Amanatova, I.R. GrishinStatistical analysis: A.V. Vereshchagina, V.A. AmanatovaDrafting the article: A.V. Vereshchagina, T.M. UskachCritical revision of the article: A.V. Vereshchagina, T.M. Uskach, O.V. SapelnikovFinal approval of the version to be published: A.V. Vereshchagina, T.M. Uskach, O.V. Sapelnikov, V.A. Amanatova, I.R. Grishin
Aim: to study the effect of cardiac contractility modulation (CCM) in patients with chronic heart failure (CHF) and atrial fibrillation (AF). Materials and methods. In a group of 100 patients with CHF and AF, the following studies were performed before implantation of the CCM and after 6 months of follow-up: 12-channel ECG, transthoracic Echocardiography, 6-minute walk test, determination of the level of pro-natriuretic N-terminal peptide (NT-proBNP), and a questionnaire based on the Minnesota quality of life questionnaire for patients with CHF (MHFLQ). All patients received long-term optimal medication therapy for CHF before surgery. Results. The results show a positive effect of the use of MCC in patients with CHF and AF on reverse LV remodeling, functional class of CHF, and levels of NT-pro-BNP regardless of the form of AF. Conclusion. The use of MCC may be a promising treatment method in addition to optimal medication therapy in patients with CHF and AF.
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