rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2012-8-5-655-660rpcardio-578Research ArticleORIGINAL STUDIESОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯPOSSIBLE PREDICTORS OF ATRIAL FIBRILLATION RECURRENCE IN LONG-TERM PROPHYLACTIC PROPAFENONE THERAPYВОЗМОЖНЫЕ ПРЕДИКТОРЫ РЕЦИДИВИРОВАНИЯ ФИБРИЛЛЯЦИИ ПРЕДСЕРДИЙ НА ФОНЕ ДЛИТЕЛЬНОГО ПРОФИЛАКТИЧЕСКОГО ПРИЕМА ПРОПАФЕНОНАКурбановР. Д.KurbanovR. D.

д.м.н., профессор, директор

ЗакировН. У.ZakirovN. U.

д.м.н., гл.н.с. и руководитель лаборатории аритмий сердца

АзизовШ. К.AzizovSh. K.

м.н.с. лаборатории аритмий сердца

РаубжановХ. М.RaubzhanovKh. M.

стажер-исследователь-соискатель лаборатории аритмий сердца

sher-d@rambler.ruРеспубликанский специализированный центр кардиологииРоссияRepublican Specialized Center for CardiologyRussian Federation20120601201685655660Copyright © Kurbanov R.D., Zakirov N.U., Azizov S.K., Raubzhanov K.M., 20152015Курбанов Р.Д., Закиров Н.У., Азизов Ш.К., Раубжанов Х.М.Kurbanov R.D., Zakirov N.U., Azizov S.K., Raubzhanov K.M.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/578

Aim. To identify possible predictors of atrial fibrillation (AF) recurrence in 6-month prophylactic propafenone therapy. Material and methods. Patients (n=63; aged 52.2±12.6 years; 25.4% women) with frequent AF recurrences who restored sinus rhythm with propafenone, were included into the study. Paroxysmal AF was observed in 84.1% of patients, and persistent AF — in 15.9% of patients. ECG, transthoracic echocardiography , chest radiography with the calculation of cardio-thoracic index (CTI) was performed at baseline. All patients received rpropafenone therapy (450–600 mg/day) during 6 months after sinus rhythm conversion. ECG and 24-hours ECG monitoring were performed in 1, 3 and 6 months of the therapy. Patients with 70–100% reduction in AF recurrence rate were included into the 1-st group, and patients with <70% reduction – into the 2-nd group. Results. 92%, 88.5% and 78% of patients were included into the group 1 after 1, 3 and 6 months of follow up, respectively. AF recurrences were observed 4.5, 3.8, and 1.7 times more often in women than these in men after 1, 3 and 6 months, respectively , (p>0.05). Mean age of patients in the group 2 was significantly older than this in patients of the group 1 (p<0.05). CTI, left atrium size and volume, interventricular septum thickness (IVST) were significantly larger in group 2. Myocardium mass of the left ventricle (MMLV) after 6 months of therapy was larger by 13.9% in patients of the group 2 vs this in patients of the group 1 (p<0.05). Conclusion. Insufficient preventive effect of propafenone was observed in 8%, 11.5% and 22% of patients in 1, 3 and 6 months of the follow-up, respectively. Propafenone prophylactic efficacy was slightly higher in men and younger patients. Patients with poor preventive effect of propafenone had a significantly larger baseline CTI, size and volume of the left atrium, IVST, and MMLV.

Цель. Определить возможные предикторы рецидивирования фибрилляции предсердий (ФП) на фоне профилактического приема пропафенона в течение 6 мес. Материал и методы. В исследование включено 63 больных (возраст 52,2±12,6 лет; 25,4% женщин) с частыми рецидивами ФП, у которых синусовый ритм был восстановлен пропафеноном. У 84,1% больных имелась пароксизмальная, а у 15,9% — персистирующая форма ФП. Исходно выполняли ЭКГ , трансторакальную эхокардиографию, рентгенографию грудной клетки с вычислением кардио-торакального индекса (КТИ). Всем больным после восстановления синусового ритма назначали пропафенон в дозе 450–600 мг/сут в течение 6 мес. ЭКГ и суточное мониторирование ЭКГ выполняли через 1, 3 и 6 мес приема пропафенона. Пациенты со снижением частоты рецидивов ФП на 70–100% за 6 мес были включены в 1 группу, а при снижении частоты <70% — 2 группу.  Результаты. Через 1, 3 и 6 мес наблюдения в 1 группу были включены 92%, 88,5% и 78% больных, соответственно. Рецидивы ФП развивались в 4,5, 3,8 и 1,7 раза чаще у женщин, чем у мужчин через 1, 3 и 6 мес, соответственно (р>0,05). Средний возраст больных 2 группы был значимо старше чем в 1 группе (р<0,05). КТИ, размеры и объем левого предсердия, толщина межжелудочковой перегородки (тМЖП) были значимо больше во 2 группе. Масса миокарда левого желудочка (ММЛЖ) через 6 мес была больше во 2 группе на 13,9% (р<0,05) по сравнению с 1 группой. Заключение. Неудовлетворительный профилактический эффект пропафенона наблюдался у 8%, 11,5% и 22% больных через 1, 3 и 6 мес, соответственно. Профилактическая эффективность пропафенона оказалась несколько выше у мужчин и больных молодого возраста. Больные с неудовлетворительным профилактическим эффектом пропафенона имели значимо большие исходные значения КТИ, размера и объема левого предсердия, а также тМЖП, ММЛЖ на более поздних этапах наблюдения.

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