D. A. Yakovlev, Andrey I. Lenkin, Vera V. Stepanova, V. A. Marinin, Nikolai V. Petrov, Vladislav K. Verendeev
The given article describes the first experience of a thoracoscopic isolation of pulmonary veins and left atrial appendage excision in the North-Western State Medical University named after I.I. Mechnikov. The clinical case features a woman with a long history of paroxysmal atrial fibrillation, severe left atrium dilation, failure in a pace control drug therapy and no effect of radiofrequency catheter isolation of pulmonary veins. Additionally, there outlined the advantages and the significance of employing the method of thoracoscopic ablation in patients with symptomatic paroxysmal and long-term persistent atrial fibrillation, — in case if antiarrythmic drugs and radiofrequency catheter ablation proved ineffective, as well as in patients with a long-term persistent atrial fibrillation along with a severe left atrium dilation.
{"title":"First experience of treating patients with atrial fibrillation using thoracoscopic isolation with left atrial appendage excision in the North-Western State Medical University named after I.I. Mechnikov","authors":"D. A. Yakovlev, Andrey I. Lenkin, Vera V. Stepanova, V. A. Marinin, Nikolai V. Petrov, Vladislav K. Verendeev","doi":"10.17816/cardar625555","DOIUrl":"https://doi.org/10.17816/cardar625555","url":null,"abstract":"The given article describes the first experience of a thoracoscopic isolation of pulmonary veins and left atrial appendage excision in the North-Western State Medical University named after I.I. Mechnikov. The clinical case features a woman with a long history of paroxysmal atrial fibrillation, severe left atrium dilation, failure in a pace control drug therapy and no effect of radiofrequency catheter isolation of pulmonary veins. \u0000Additionally, there outlined the advantages and the significance of employing the method of thoracoscopic ablation in patients with symptomatic paroxysmal and long-term persistent atrial fibrillation, — in case if antiarrythmic drugs and radiofrequency catheter ablation proved ineffective, as well as in patients with a long-term persistent atrial fibrillation along with a severe left atrium dilation.","PeriodicalId":518674,"journal":{"name":"Cardiac Arrhythmias","volume":"69 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141353083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. N. Novikova, Alina E. Andreeva, F. I. Bitakova, Vladimir I. Novikov, Kristina A. Gladysheva, Polina V. Petrova, Polina A. Stalnova, Nadezhda A. Tokareva
The article presents a clinical case of a rather rare course of hypertrophic cardiomyopathy with the transformation of a hypertrophic phenotype into a dilated phenotype against the background of the “burned-out phase” phenomenon, ventricular and supraventricular rhythm disturbances, and multiple genetic mutations. Timely started disease-modifying therapy (quadruple therapy) for chronic heart failure led to reverse positive remodeling of the left chambers of the heart.
{"title":"Multifaces of hypertrophic cardiomyopathy: a case of transformation of hypertrophic phenotype into dilated","authors":"T. N. Novikova, Alina E. Andreeva, F. I. Bitakova, Vladimir I. Novikov, Kristina A. Gladysheva, Polina V. Petrova, Polina A. Stalnova, Nadezhda A. Tokareva","doi":"10.17816/cardar630134","DOIUrl":"https://doi.org/10.17816/cardar630134","url":null,"abstract":"The article presents a clinical case of a rather rare course of hypertrophic cardiomyopathy with the transformation of a hypertrophic phenotype into a dilated phenotype against the background of the “burned-out phase” phenomenon, ventricular and supraventricular rhythm disturbances, and multiple genetic mutations. Timely started disease-modifying therapy (quadruple therapy) for chronic heart failure led to reverse positive remodeling of the left chambers of the heart.","PeriodicalId":518674,"journal":{"name":"Cardiac Arrhythmias","volume":"16 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141350701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Natalia G. Kucherenko, A. Bebekh, Irina A. Umarova, Aigul R. Abukova
Obstructive sleep apnea syndrome is a common condition, especially among obese patients. Patients with obstructive sleep apnea syndrome have an increased risk of developing arterial hypertension and cardiovascular events, as well as cardiac arrhythmias, which include reflexively occurring bradyarrhythmias and episodes of asystole at night. Treatment of obstructive sleep apnea syndrome leads to an improvement in the patient’s quality of life and also reduces cardiovascular risk and eliminates associated bradyarrhythmias during night sleep.
{"title":"Obstructive sleep apnea as a potentially reversible cause of nighttime bradyarrhythmias. Clinical case","authors":"Natalia G. Kucherenko, A. Bebekh, Irina A. Umarova, Aigul R. Abukova","doi":"10.17816/cardar626655","DOIUrl":"https://doi.org/10.17816/cardar626655","url":null,"abstract":"Obstructive sleep apnea syndrome is a common condition, especially among obese patients. Patients with obstructive sleep apnea syndrome have an increased risk of developing arterial hypertension and cardiovascular events, as well as cardiac arrhythmias, which include reflexively occurring bradyarrhythmias and episodes of asystole at night. Treatment of obstructive sleep apnea syndrome leads to an improvement in the patient’s quality of life and also reduces cardiovascular risk and eliminates associated bradyarrhythmias during night sleep.","PeriodicalId":518674,"journal":{"name":"Cardiac Arrhythmias","volume":"82 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141350636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tatiana I. Balabanovich, Valentina S. Golyshko, Irina A. Sinkevich, Elen S. Shkuta, Elizaveta A. Veniadziktova, Pavel V. Baliuk, Alexei V. Knysh
This article provides the experience of examination and treatment of paroxysmal atrial fibrillation patients with concomitant obesity, arterial hypertension and/or ischemic heart disease, who were prescribed levocarnitine in addition to traditional therapy. The addition of levocarnitine in management of atrial fibrillation was found to be capable of reducing the atrial fibrillation burden after cardioversion and improve the functional state of the patients.
{"title":"Opportunities of metabolic treatment in paroxysmal atrial fibrillation patients with obesity, arterial hypertension and/or ischemic heart disease","authors":"Tatiana I. Balabanovich, Valentina S. Golyshko, Irina A. Sinkevich, Elen S. Shkuta, Elizaveta A. Veniadziktova, Pavel V. Baliuk, Alexei V. Knysh","doi":"10.17816/cardar629168","DOIUrl":"https://doi.org/10.17816/cardar629168","url":null,"abstract":"This article provides the experience of examination and treatment of paroxysmal atrial fibrillation patients with concomitant obesity, arterial hypertension and/or ischemic heart disease, who were prescribed levocarnitine in addition to traditional therapy. The addition of levocarnitine in management of atrial fibrillation was found to be capable of reducing the atrial fibrillation burden after cardioversion and improve the functional state of the patients.","PeriodicalId":518674,"journal":{"name":"Cardiac Arrhythmias","volume":"28 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141353783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Komissarova, N. Rineiska, N. Chakova, S. Niyazova, L. Plashchinskaya, Veronika Ch. Barsukevich, Olga V. Podpalova
AIM: of the study was to evaluate the clinical and genetic characteristics, including the development of adverse events and outcomes in patients with catecholaminergic polymorphic ventricular tachycardia (CPVT). MATERIALS AND METHODS: The clinical phenotype of eight patients with CPVT, two of whom were relatives of probands, was observed over 4 years. The clinical and instrumental study included ECG-12, 24-hour Holter ECG monitoring, genealogical history collection and family history of sudden cardiac death (SCD), transthoracic echocardiography and cardiac magnetic resonance imaging to detect structural myocardial changes, electrophysiologic study according to indications, and ICD monitoring. High-throughput sequencing (NGS) was utilized to search for mutations in genes linked to the onset of channelopathies and other inherited rhythm disorders. RESULTS: In 8 patients, nucleotide variants of pathogenicity classes III-V were identified according to the ACMG (2015) criteria in the RYR2 gene associated with CPVT. Pathogenic (IV-V class) and likely pathogenic (IV class) mutations in the RYR2 gene were found in 6 (75%) probands, variants with uncertain clinical significance (VUS, class III) were found in 2 patients. At the time of diagnosis, transient QTc interval prolongation of more than 480 ms was detected in 4 (50%) patients; bradycardia less than 54 beats/min — in 2 (25%) patients, sequences of supraventricular tachycardia and ventricular tachyarrhythmia — in 2 (25%) patients. The most severe form of the disease with marked clinical manifestations and an episode of clinical death with subsequent resuscitation, as well as a transient QTc interval prolongation exceeding 500 ms was observed in patients with mutations c.11814C A (p.Ser3938Arg, rs794728704); c.463G A (p.Gly155Arg) and c.14876G A (p.Arg4959Gln, rs794728811) in the RYR2 gene. Three (37.5%) patients underwent ICD implantation; one for primary SCD prevention and two for secondary prevention. CONCLUSION: In this study, the spectrum of clinical manifestations in patients with genetically confirmed CPVT was examined. The findings highlight transient QTc interval extensions, significant sinus bradycardia, and sequences of supraventricular tachyarrhythmias, which can escalate into life-threatening ventricular tachyarrhythmias in CPVT patients.
{"title":"Clinical and genetic characterization of patients with catecholaminergic polymorphic ventricular tachycardia: a case series","authors":"S. Komissarova, N. Rineiska, N. Chakova, S. Niyazova, L. Plashchinskaya, Veronika Ch. Barsukevich, Olga V. Podpalova","doi":"10.17816/cardar568180","DOIUrl":"https://doi.org/10.17816/cardar568180","url":null,"abstract":"AIM: of the study was to evaluate the clinical and genetic characteristics, including the development of adverse events and outcomes in patients with catecholaminergic polymorphic ventricular tachycardia (CPVT). \u0000MATERIALS AND METHODS: The clinical phenotype of eight patients with CPVT, two of whom were relatives of probands, was observed over 4 years. The clinical and instrumental study included ECG-12, 24-hour Holter ECG monitoring, genealogical history collection and family history of sudden cardiac death (SCD), transthoracic echocardiography and cardiac magnetic resonance imaging to detect structural myocardial changes, electrophysiologic study according to indications, and ICD monitoring. High-throughput sequencing (NGS) was utilized to search for mutations in genes linked to the onset of channelopathies and other inherited rhythm disorders. \u0000RESULTS: In 8 patients, nucleotide variants of pathogenicity classes III-V were identified according to the ACMG (2015) criteria in the RYR2 gene associated with CPVT. Pathogenic (IV-V class) and likely pathogenic (IV class) mutations in the RYR2 gene were found in 6 (75%) probands, variants with uncertain clinical significance (VUS, class III) were found in 2 patients. At the time of diagnosis, transient QTc interval prolongation of more than 480 ms was detected in 4 (50%) patients; bradycardia less than 54 beats/min — in 2 (25%) patients, sequences of supraventricular tachycardia and ventricular tachyarrhythmia — in 2 (25%) patients. The most severe form of the disease with marked clinical manifestations and an episode of clinical death with subsequent resuscitation, as well as a transient QTc interval prolongation exceeding 500 ms was observed in patients with mutations c.11814C A (p.Ser3938Arg, rs794728704); c.463G A (p.Gly155Arg) and c.14876G A (p.Arg4959Gln, rs794728811) in the RYR2 gene. Three (37.5%) patients underwent ICD implantation; one for primary SCD prevention and two for secondary prevention. \u0000CONCLUSION: In this study, the spectrum of clinical manifestations in patients with genetically confirmed CPVT was examined. The findings highlight transient QTc interval extensions, significant sinus bradycardia, and sequences of supraventricular tachyarrhythmias, which can escalate into life-threatening ventricular tachyarrhythmias in CPVT patients.","PeriodicalId":518674,"journal":{"name":"Cardiac Arrhythmias","volume":"18 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140531700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. S. Postol, G. N. Antipov, A. V. Ivanchenko, Vitaliy V. Lyashenko, D. A. Kalinin, S. Kotov, A. B. Vygovsky, Yuriy A. Shneider
AIM: To study EFI parameters and features of recurrent atrial tachyarrhythmias in patients who underwent surgical correction of AF. MATERIALS AND METHODS: from January 2013 to December 2021, 447 combined interventions were performed to eliminate AF using the labyrinth-3 and left atrial labyrinth techniques with correction of CHD (congenital heart disease) and/or coronary artery disease. Rhythm disturbances were detected in 57 (12.7%) patients at various follow-up periods. Endovascular interventions were performed in 39 patients. The average follow-up period after the endocardial stage was 34.37 (standard deviation 24.32) months. The median age of patients was 64 (58–67) years, 21 (54%) were men. The patients were divided into 2 groups: group 1 — after the classic biatrial (BA) labyrinth-3 — 23 (59%) patients, group 2 — after the left-atrial variant (LA) labyrinth-3 — 16 (41%) patients. At the endocardial stage, electrophysiological studies (EFI) were performed to clarify the mechanism of arrhythmia, and ablation eliminated tachyarrhythmia. EFI protocol: revision of the pulmonary veins, determination of the isolation of the posterior wall of the LA assessment of atrial arrhythmia, elimination of arrhythmia, control induction of arrhythmia after ablation. After repeated intervention, patients were observed in the operating clinic every 3 months. RESULTS: After the endocardial stage, a regular rhythm was determined in 19 (82.6%) patients of the BA group, 13 (92.9%) patients of the LA group (p = 0.914). Relapses in the form of AF were noted in 5 patients (4 — group 1 and 1 — group 2) group (p = 0.306) All relapses of tachyarrhythmia with an irregular cycle (AF) were detected in patients with AF before the endovascular stage In both groups, there were cases of restoration of conduction in the pulmonary veins — 10 (43.5%) patients after BA ablation and 1 (5.3%) patient after LA ablation. There are no recurrences of atrial arrhythmia after ablation of atrial flutter (arrhythmia with a stable cycle). CONCLUSION: The endocardial stage is highly effective and demonstrates subsequent freedom from atrial arrhythmia in patients who have tachycardia with a regular cycle after both methods of surgical ablation of AF. Recurrent tachyarrhythmia in the form of AF (irregular cycle) is associated with a low probability of maintaining a regular atrial rhythm after a repeated endocardial procedure, due to the presence of structural and electrophysiological changes in the atrial myocardium.
{"title":"Analysis of the endocardial stage of treatment of tachyarhythmias after open interventions for atrial fibrillation. Experience of one center","authors":"A. S. Postol, G. N. Antipov, A. V. Ivanchenko, Vitaliy V. Lyashenko, D. A. Kalinin, S. Kotov, A. B. Vygovsky, Yuriy A. Shneider","doi":"10.17816/cardar529671","DOIUrl":"https://doi.org/10.17816/cardar529671","url":null,"abstract":"AIM: To study EFI parameters and features of recurrent atrial tachyarrhythmias in patients who underwent surgical correction of AF. \u0000MATERIALS AND METHODS: from January 2013 to December 2021, 447 combined interventions were performed to eliminate AF using the labyrinth-3 and left atrial labyrinth techniques with correction of CHD (congenital heart disease) and/or coronary artery disease. \u0000Rhythm disturbances were detected in 57 (12.7%) patients at various follow-up periods. Endovascular interventions were performed in 39 patients. The average follow-up period after the endocardial stage was 34.37 (standard deviation 24.32) months. The median age of patients was 64 (58–67) years, 21 (54%) were men. The patients were divided into 2 groups: group 1 — after the classic biatrial (BA) labyrinth-3 — 23 (59%) patients, group 2 — after the left-atrial variant (LA) labyrinth-3 — 16 (41%) patients. \u0000At the endocardial stage, electrophysiological studies (EFI) were performed to clarify the mechanism of arrhythmia, and ablation eliminated tachyarrhythmia. EFI protocol: revision of the pulmonary veins, determination of the isolation of the posterior wall of the LA assessment of atrial arrhythmia, elimination of arrhythmia, control induction of arrhythmia after ablation. After repeated intervention, patients were observed in the operating clinic every 3 months. \u0000RESULTS: After the endocardial stage, a regular rhythm was determined in 19 (82.6%) patients of the BA group, 13 (92.9%) patients of the LA group (p = 0.914). Relapses in the form of AF were noted in 5 patients (4 — group 1 and 1 — group 2) group (p = 0.306) All relapses of tachyarrhythmia with an irregular cycle (AF) were detected in patients with AF before the endovascular stage In both groups, there were cases of restoration of conduction in the pulmonary veins — 10 (43.5%) patients after BA ablation and 1 (5.3%) patient after LA ablation. There are no recurrences of atrial arrhythmia after ablation of atrial flutter (arrhythmia with a stable cycle). \u0000CONCLUSION: The endocardial stage is highly effective and demonstrates subsequent freedom from atrial arrhythmia in patients who have tachycardia with a regular cycle after both methods of surgical ablation of AF. Recurrent tachyarrhythmia in the form of AF (irregular cycle) is associated with a low probability of maintaining a regular atrial rhythm after a repeated endocardial procedure, due to the presence of structural and electrophysiological changes in the atrial myocardium.","PeriodicalId":518674,"journal":{"name":"Cardiac Arrhythmias","volume":"11 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140531527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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