Safety and Effectiveness of Electrical and Pharmacological Cardioversion in Persistent Atrial Fibrillation. Part I: Study Rationale, Design and Assessment of Effectiveness

Mironov, N. Yu.; Vlodzyanovskiy, V. V.; Yuricheva, Yu. A.; Соколов, С. Ф.; Golitsyn, S. P.; Rosenstraukh, L. V.; Chazov, E. I.

doi:10.20996/1819-6446-2018-14-5-664-669

Cited by 21 publications

(6 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Основным механизмом его действия является подавление входящего калиевого тока, приводящего к удлинению реполяризации и рефрактерных периодов миокарда [93]. Этот препарат при использовании его с целью восстановления синусового ритма у больных с персистирующей ФП по эффективности не уступает электроимпульсной терапии [94,95]. Рефралон применяется внутривенно.…”

Section: History Of Use Of Antiarrhythmic Drugs история применения ан...unclassified

Historical Aspects of the Use of Antiarrhythmic Drugs in Clinical Practice

Doshchitsin

Тарзиманова

2022

Racionalʹnaâ farmakoterapiâ v kardiologii

View full text Add to dashboard Cite

Heart rhythm disorders are one of the most urgent problems in cardiology. The first reports on the possibility of using drugs in the treatment of cardiac arrhythmias began to appear in the scientific literature from the middle of the 18th century. This pharmacotherapeutic direction has been developed since the second half of the 20th century, when new antiarrhythmic drugs began to be used in clinical practice. The introduction of new drugs and modern methods of treating arrhythmias into clinical practice has significantly improved the prognosis and quality of life of patients. Combination antiarrhythmic therapy, including antiarrhythmic drugs and radiofrequency ablation, seems to be the most promising and successful tactic for treating patients in the future. A historical review of the literature on the clinical use of antiarrhythmic drugs both in past years and at present is presented in the article.

show abstract

Section: History Of Use Of Antiarrhythmic Drugs история применения ан...unclassified

Historical Aspects of the Use of Antiarrhythmic Drugs in Clinical Practice

Doshchitsin

Тарзиманова

2022

Racionalʹnaâ farmakoterapiâ v kardiologii

View full text Add to dashboard Cite

show abstract

“…Согласно текущим рекомендациям, тактика контроля ритма у пациентов с пароксизмальной ФП включает назначение антиаритмических препаратов (ААП) или выполнение катетерной абляции с изоляцией устьев легочных вен (ЛВ) [2,3]. В настоящее время в арсенале врачей появились высокоэффективные ААП, которые позволяют восстанавливать синусовый ритм у пациентов даже с персистирующей и дли-тельно персистирующей ФП [4,5]. Однако препараты для профилактики рецидивов значительно уступают катетерным методам лечения.…”

Section: результатыunclassified

Potential risk factors of atrial fibrillation recurrence after cryoballoon ablation

Новиков

Mironov

et al. 2022

Kardiologiia

Self Cite

View full text Add to dashboard Cite

Aim To identify risk factors for recurrence of atrial fibrillation (AF) following cryoballoon ablation (CBA).Material and methods This prospective study included patients with paroxysmal AF who had undergone CBA (141 patients, median age 60 years, 3% men). The evaluation prior to CBA included clinical instrumental parameters (electrocardiography (ECG), 24-h ECG monitoring, echocardiography, contrast-enhanced cardiac multispiral computed tomography). Also, possible intraoperative indexes that could affect the CBA effectivity, were evaluated. The postoperative follow-up duration was 12 months. Effectivity was assessed during in-person visits at 3, 6, and 12 months, when questioning of patients and 24-h ECG monitoring were performed. CBA was considered ineffective if the patient had recurrences of any atrial tachyarrhythmia longer than 30 sec after the end of the 3-month “blind” period.Results During the 12-month follow-up, recurrences of atrial tachyarrhythmia were observed in 46 (32.6 %) patients. Patients with ineffective CBA more frequently had AF during the first 3 months (71.7 % vs. 11.6 %; р<0.001). Such patients had a history of multiple ineffective treatments with antiarrhythmic drugs (AAD), common pulmonary venous (PV) collector (41.3 % vs. 20.0 %; р=0.008), and stroke/recurrent ischemic attacks (15.2 % vs. 5.2 %; р=0.047). Multifactorial regression analysis showed that the factors of AF recurrence included common PV collector (relative risk (RR) 2.35; 95 % confidence interval (CI) 1.29–4.25; р=0.005), multiple ineffective AADs (RR 1.42; 95 % CI 1.08–1.86; р=0.011), and early AF recurrence (RR 7.57; 95 % CI 3.84–14.90; р<0.001).Conclusion Common PV collector and multiple ineffective AADs are risk factors of ineffective CBA. Early recurrences during the first 3 postoperative months are a significant risk factor of long-term AF recurrences.

show abstract

“…Дизайн проведенного исследования, оценка мощности, критерии включения и исключения больных, рандомизация, принцип замещения выбывших больных, а также использованные статистические методы рассмотрены в первой части статьи. Там же подробно описаны процедуры МКВ и ЭКВ, выполнявшиеся включенным больным [7].…”

Section: материал и методыunclassified

“…В группы МКВ и ЭКВ включены по 30 больных. Статистически значимые различия по основным анализируемым параметрам между двумя группами больных выявлены не были [7].…”

Section: результаты клиническая характеристика больныхunclassified

Safety and Effectiveness of Electrical and Pharmacological Cardioversion in Persistent Atrial Fibrillation. Part 2: Assessment of Safety

Mironov

Vlodzyanovskiy

Yuricheva

et al. 2019

Racionalʹnaâ farmakoterapiâ v kardiologii

Self Cite

View full text Add to dashboard Cite

Aim. To compare safety of new class III antiarrhythmic drug Refralon with direct current cardioversion (DCC) in patients with persistent atrial fibrillation (AF). Material and methods. 60 patients with persistent AF were randomized to groups of DCC (n=30) and pharmacologic conversion (PCV; n=30). There were no significant differences in age, sex, AF duration, concomitant cardiovascular diseases, CHA2DS2-VASc score and echocardiographic parameters between the groups compared. Initial assessment excluded contraindications to restore sinus rhythm (SR). In DCC group two attempts using biphasic synchronized shocks of 150 J and 170 J were performed. In PCV group patients received up to three subsequent intravenous injections of Refralon 10 μg/kg (maximal dose 30 μg/kg). Results. There were no mortality, stroke, transient ischemic attack, ventricular arrhythmia, asystole longer than 3,0 sec (primary safety criteria) in both groups. Prolongation of QT interval longer than 500 ms observed in 1 of 30 patients (3,3%) in DCC group and in 7 of 30 patients (23,3%) in PCV group. 2 patients (one patient in each group; 3,3%) developed asymptomatic bradycardia after conversion to SR that resolved spontaneously within 30 minutes. 95% confidence interval (95%CI) for secondary safety criteria is [0,02-0,38] for QT prolongation and [-0,04-0,04] for bradycardia. Conclusion. Safety of PCV is noninferior to DCC in patients with persistent AF in terms of primary safety criteria and bradyarrhythmias. More frequent QT interval prolongation to values >500 ms observed in PCV group points to necessity of precautions with use of the drug.

show abstract

Safety and Effectiveness of Electrical and Pharmacological Cardioversion in Persistent Atrial Fibrillation. Part I: Study Rationale, Design and Assessment of Effectiveness

Cited by 21 publications

References 4 publications

Historical Aspects of the Use of Antiarrhythmic Drugs in Clinical Practice

Historical Aspects of the Use of Antiarrhythmic Drugs in Clinical Practice

Potential risk factors of atrial fibrillation recurrence after cryoballoon ablation

Safety and Effectiveness of Electrical and Pharmacological Cardioversion in Persistent Atrial Fibrillation. Part 2: Assessment of Safety

Contact Info

Product

Resources

About