Options for antiarrhythmic therapy after surgical treatment of the atrial fibrillation

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Abstract

Aim. To assess the afficiency of using different shcemes of the antiarrythmic therapy (AAT) after the surgical treatment of the atrial fibrillation (AF).Material and methods. This retrospective study included 279 patients: 141 (49%) females and 168 (51%) males, aged 59±7.9 years who had got Сox-Maze IV procedure at Federal cardiovascular center (Penza). 27 patient (9.7%) had the paroxysmal AF, 252 (90.3%) - the persistent one. The AF’s duration was 36 months (from 1 to 180). The size of the left atrium was average 52.4±8.4 mm (from 40 to 82 mm). The medium functional class (FC) of heart failure (HF) (NYHA) was 2.8±0.4: II FC-63 (22.6%), III FC - 213 (76.3%), IV FC - 3 (1.1%). There were 3 groups of patients:1 group had 57 patients who had got amiodaron over 6 months; 2 group - 126 patients who had got b-blocker (b-B) (bisoprolol) long monotherapy; 3 group - 96 patients who had got amiodaron during 3-6 months then had got bisoprolol long therapy. All patiens got Cox-Maze IV procedure.Results. Remote results assessed after 6 months-3 years period after the operation. In all groups the number of patients with I and II FC HF increased; there was significant difference at 2 group (p1-2=0.01; p2-3=0.01; p1- 3=0.73). And there were more patients with sinus rhythm at 2 group than at 3 group significantly. The freedom from AF at 1 group was 77%±0.89, at 2 group - 68%±0.98, at 3 group - 85%±0.95 with the significant difference between 2 and 3 groups (р1-2=0.61; p1-3=0.13; p2-3=0.01).Conclusions. AAT by amiodaron during 3-6 months and then by beta-blocker (bisoprolol) longly after Cox-Maze IV procedure allows to keep sinus rhythm to 85% patiens at the distant period of time and comparing with the b-blocker-monotherapy allows to keep sinus rhythm more effectively. The difference of efficiency by long amiodaron-monotherapy and amiodaron-therapy during 3-6 months is not got statistical significant after Cox-Maze IV procedure.

About the authors

V. V Bazylev

Federal Centre of Cardiovascular Surgery of the Ministry of Health of the Russian Federation

д-р. мед. наук, гл. врач ФГБУ ФЦССХ 440071, Russian Federation, Penza, ul. Stasova, d. 6

E. V Nemchenko

Federal Centre of Cardiovascular Surgery of the Ministry of Health of the Russian Federation

д-р мед. наук, зав. кардиохирургическим отд-нием №1 ФГБУ ФЦССХ 440071, Russian Federation, Penza, ul. Stasova, d. 6

G. N Abramova

Federal Centre of Cardiovascular Surgery of the Ministry of Health of the Russian Federation

Email: galana2004@mail.ru
канд. мед. наук, врач-кардиолог ФГБУ ФЦССХ 440071, Russian Federation, Penza, ul. Stasova, d. 6

V. A Karnakhin

Federal Centre of Cardiovascular Surgery of the Ministry of Health of the Russian Federation

врач-сердечно-сосудистый хирург ФГБУ ФЦССХ 440071, Russian Federation, Penza, ul. Stasova, d. 6

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