rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2012-8-2-196-200rpcardio-558Research ArticleNOTES FROM PRACTICEКЛИНИЧЕСКИЙ ОПЫТ1C-INDUCED ATRIAL FLUTTER IN A PATIENT WITH WPW SYNDROME: CASE REPORT AND REVIEW1С-ИНДУЦИРОВАННОЕ ТРЕПЕТАНИЕ ПРЕДСЕРДИЙ У ПАЦИЕНТА С СИНДРОМОМ WPW: КЛИНИЧЕСКИЙ СЛУЧАЙ И ОБЗОР ЛИТЕРАТУРЫМаматказинаР. Р.MamatkazinaR. R.

аспирант отдела сердечно-сосудистой хирургии 

КолосИ. П.KolosI. P.

к.м.н., с.н.с. отдела клинической кардиологии и молекулярной генетики

docsn173@yandex.ruСердюкС. Е.SerdyukS. E.

к.м.н., с.н.с. отдела клинической кардиологии и молекулярной генетики

МазыгулаЕ. П.MazygulaE. P.

к.м.н., главный врач

СвешниковА. В.SveshnikovA. V.

к.м.н., руководитель группы лечения нарушений ритма сердца 

Институт клинической кардиологии им. А.Л. Мясникова, Российский кардиологический научно-производственный комплексРоссияInstitute of Clinical Cardiology named after A.L. Myasnikov , Russian Cardiology Research and Production ComplexRussian FederationГосударственный научно-исследовательский центр профилактической медициныРоссияState Research Center for Preventive MedicineRussian FederationРоссийский национальный медико-хирургический центр им. Н.И. ПироговаРоссияRussian National Medical and Surgical Center named after N.I. PirogovRussian Federation20120301201682196200Copyright © Mamatkazina R.R., Kolos I.P., Serdyuk S.E., Mazygula E.P., Sveshnikov A.V., 20152015Маматказина Р.Р., Колос И.П., Сердюк С.Е., Мазыгула Е.П., Свешников А.В.Mamatkazina R.R., Kolos I.P., Serdyuk S.E., Mazygula E.P., Sveshnikov A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/558

The clinical case of a rare proarrhythmic effect of antiarrhythmic drugs with a poor prognosis (medication-induced atrial flutter in a patient with "malignant" Kent’s bundle) is presented. Radiofrequency ablation (RFA) is the most justified treatment method in patients with WPW-syndrome and "malignant" Kent’s bundle. RFA in descripted case has been postponed due to technical reasons. While waiting for RFA and after consideration of the potential risks and benefits the decision to use antiarrhythmic drugs to block the additional bundle was made. Paroxysm of broad-complex tachycardia developed on the third day of the treatment. It was regarded as a paroxysm of atrial fibrillation/flutter in the patient with WPW syndrome induced by taking antiarrhythmic drugs class 1C (allapinine). Review of the literature on the atrial fibrillation induced by antiarrhythmic of 1C class, and association of atrial fibrillation with WPW-syndrome is presented.

Представлен клинический пример редкой формы прогностически неблагоприятного проаритмогенного действия антиаритмических препаратов — медикаментозно индуцированного трепетания предсердий у пациента со «злокачественным» пучком Кента. Наиболее оправданным у пациентов с WPW-синдромом и «злокачественным» пучком Кента видится проведение радиочастотной аблации (РЧА), но в данном случае по техническим причинам РЧА была отложена. В период ожидания РЧА после учета потенциального риска и пользы было принято решение о назначении антиаритмических препаратов с целью блокирования проведения по дополнительному пути. На третьи сутки приема аллапинина развился пароксизм «широкой» тахикардии, расцененный как пароксизм мерцания/трепетания предсердий у пациента с синдромом WPW, индуцированного приемом антиаритмического препарата 1С-класса (аллапинин). Представлен обзор литературы по мерцательной аритмии, индуцированной антиаритмиками 1С-класса и сочетанию мерцания предсердий с WPW-синдромом.

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