References

inovmed

Инновационная медицина Кубани

Innovative Medicine of Kuban

2541-9897

Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1

inovmed-58

Research Article

ОБЗОРЫ

REVIEWS

КАТЕТЕРНАЯ АБЛАЦИЯ ФИБРИЛЛЯЦИИ ПРЕДСЕРДИЙ: ВЧЕРА, СЕГОДНЯ, ЗАВТРА

ATRIAL FIBRILLATION CATHETER ABLATION: YESTERDAY, TODAY, TOMORROW

Лебедев

Д. С.

Lebedev

D. S.

lebedevdmitry@mail.ru

Национальный медицинский исследовательский центр им. В.А. Алмазова Министерства здравоохранения РФРоссияAlmazov National Medical Research Centre, Ministry of Health of the Russian FederationRussian Federation

2017

30032017

515765

2017

Лебедев Д.С.

Lebedev D.S.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.innovmedkub.ru/jour/article/view/58

В обзорной статье приводятся данные об эпидемическом характере распространения фибрилляции предсердий (ФП) в наши дни, экономические и социальные последствия резкого увеличения количества пациентов. Обсуждается стратегия лечения ФП, значительное ограничение возможностей медикаментозного лечения. Интервенционное лечение было разработано после открытия электрической активности легочных вен и ее связи с индукцией и персистированием аритмии. Подробно обсуждается методика катетерной аблации у больных с пароксизмальной и персистирующей фибрилляцией предсердий. Показано, что несмотря на ряд дополнительных приемов и подходов в катетерной аблации, краеугольным камнем успешного лечения ФП остается изоляция легочных вен. Сегодня существует два основных подхода катетерного лечения – радиочастотная и криобаллонная изоляция легочных вен. Внедрение новых модификаций криобаллона позволяет сократить время операции, снизить вероятность осложнений. Обсуждается необходимость комплексного подхода к лечению больных с персистирующими формами аритмии, осложнения и возможности новых технологий. Подчеркивается важность командного подхода в лечении больных с фибрилляцией предсердий.

In the present article we demonstrate data on epidemic nature of atrial fibrillation spread (AF) today, and describe economic and social consequences of abrupt increase in patient numbers. The strategy of AF treatment and significant restriction in opportunities of drug treatment is discussed. Intervention treatment was developed after discovery of pulmonary vein electric activity and its connection with induction and persisting arrhythmia. We described in details technique of catheter ablation in patients with paroxysmal and persisting atrial fibrillation. It is shown that despite a row of additional acceptances and approaches in catheter ablation, pulmonary vein isolation remains a cornerstone for AF successful treatment. Today there are two main approaches for catheter treatment: radio-frequency and cryoballoon isolation of pulmonary veins. Introduction of new modifications with a cryocylinder allows to reduce operation time and shorten complication development probability. Necessity for integrated approach to treat patients with persisting arrhythmia, further complications and possibility to develop new technologies is discussed. We consider team approach in treatment this category of patients to be extremely important.

фибрилляция предсердийлегочные веныкатетерная аблация

atrial fibrillationpulmonary veinscatheter ablation

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The authors declare that there are no conflicts of interest present.