clinmedКлиническая медицинаClinical Medicine (Russian Journal)0023-21492412-1339ООО «Медицинское информационное агентство»10.30629/0023-2149-2020-98-9-10-685-690clinmed-144Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL INVESTIGATIONSМатематическая модель прогнозирования постабляционной фибрилляции предсердий у пациентов с типичным трепетанием предсердийMathematical model for forecasting postablative atrial fibrillation in patients with typical atrial flutterhttps://orcid.org/0000-0002-9919-2203ЕмельяненкоМ. В.EmelyanenkoM. V.

Емельяненко Михаил Владимирович — преподаватель кафедры терапии неотложных состояний

107392, Москва

Mikhail V. Emelyanenko — lecturer of the Department of emergency therapy of the branch

107392, Moscow

sudmed1@gmail.comhttps://orcid.org/0000-0003-1843-087XОвчинниковЮ. В.OvchinnikovYu. V.

107392, Москва

107392, Moscow

СтекловВ. И.SteklovV. I.

107392, Москва

107392, Moscow

ЕмельяненкоВ. М.EmelyanenkoV. M.

117997, Москва

601900, Ковров

117997, Moscow

601900, Kovrov

Филиал ФГБВОУ ВО «Военно-медицинская академия им. С.М. Кирова» Минобороны РоссииРоссияMilitary Medical Academy named after Kirov S.M. (branch) Ministry of Defense of the Russian FederationRussian FederationФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России; ООО «Первый клинический медицинский центр»РоссияPirogov Russian National Research Medical University of the Ministry of Health of Russian Federation; First Clinical Medical Center LLCRussian Federation202026032021989-10685690Copyright © Емельяненко М.В., Овчинников Ю.В., Стеклов В.И., Емельяненко В.М., 20212021Емельяненко М.В., Овчинников Ю.В., Стеклов В.И., Емельяненко В.М.Emelyanenko M.V., Ovchinnikov Y.V., Steklov V.I., Emelyanenko V.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.clinmedjournal.com/jour/article/view/144

В статье представлены клинические, инструментальные и электрофизиологические предикторы возникновения постабляционной фибрилляции предсердий (ФП) после радиочастотной абляции (РЧА) кавотрикуспидального истмуса у 209 пациентов с типичным трепетанием предсердий (ТТП). Проанализированы результаты собственного опыта лечения этих больных. Описана методика модифицированного интраоперационного электрофизиологического теста индукции ФП у больных с ТТП. Проведена оценка роли указанной методики в возникновении постабляционной ФП. Разработана математическая модель прогнозирования постабляционной ФП на интраоперационном этапе лечения пациентов с ТТП.

The article represents clinical, instrumental and electrophysiological predictors of postablative atrial fi brillation (AF) occurrence after radiofrequency ablation of cavotricuspid isthmus in 209 patients with typical atrial fl utter. The results of our own experience in the treatment of these patients are analyzed. The technique of the modifi ed intraoperative electrophysiological test of AF induction in patients with typical atrial fl utter is described. The role of this technique in the occurrence of postablative AF is evaluated. A mathematical model for predicting postablative AF at the intraoperative stage of treatment of patients with typical atrial fl utter has been developed.

типичное трепетание предсердийрадиочастотная абляциякавотрикуспидальный истмуспредикторы фибрилляции предсердийэлектрофизиологический провокационный тестtypical atrial fl utterradiofrequency ablationcavotricuspid isthmuspredictors of atrial fi brillationelectro-physiological provocative testReferencesC hugh S.S., Havmoeller R., Narayanan K. et al. Worldwide epidemiology of atrial fi brillation: a Global Burden of Disease 2010 Study. Circulation. 2014;129(8):837–47.C hugh S.S., Havmoeller R., Narayanan K. et al. Worldwide epidemiology of atrial fi brillation: a Global Burden of Disease 2010 Study. Circulation. 2014;129(8):837–47.A lonso A., Bengtson L.G. A rising tide: the global epidemic of atrial fi brillation. Circulation. 2014;129:829–830.A lonso A., Bengtson L.G. A rising tide: the global epidemic of atrial fi brillation. Circulation. 2014;129:829–830.M ozaff arian D., Benjamin E.J., Go A.S., Arnett D.K., Blaha M.J., Cushman M. et al. Heart disease and stroke statistics-2016 update: a report from the American Heart Association. Circulation. 2016;133(4):e38–360. DOI: 10.1161/CIR.0000000000000350.M ozaff arian D., Benjamin E.J., Go A.S., Arnett D.K., Blaha M.J., Cushman M. et al. Heart disease and stroke statistics-2016 update: a report from the American Heart Association. Circulation. 2016;133(4):e38–360. DOI: 10.1161/CIR.0000000000000350.K im M.H., Johnson S.S., Chu B.C., Dalal M.R., Schulman K.L. Estimation of total incremental health care costs in patients with atrial fi brillation in the United States. Circ. Cardiovasc. Qual Outcomes. 2011;4:313–320.K im M.H., Johnson S.S., Chu B.C., Dalal M.R., Schulman K.L. Estimation of total incremental health care costs in patients with atrial fi brillation in the United States. Circ. Cardiovasc. Qual Outcomes. 2011;4:313–320.W aldo A.L., Feld G.K. Inter-relationships of atrial fi brillation and atrial fl utter: mechanisms and clinical implications. J. Am. Coll. Cardiol. 2008;51:779–786.W aldo A.L., Feld G.K. Inter-relationships of atrial fi brillation and atrial fl utter: mechanisms and clinical implications. J. Am. Coll. Cardiol. 2008;51:779–786.A CC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias – executive summary. J. Am. Coll. Cardiol. 2003;42(8):1493–531.A CC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias – executive summary. J. Am. Coll. Cardiol. 2003;42(8):1493–531.L ee Y.S., Hyun D.W., Jung B.C. et al. KTK Cardiac Electrophysiology Working Group. Left atrial volume index as a predictor for occurrence of atrial fi brillation after ablation of typical atrial fl utter. J. Cardiol. 2010;56:348–53.L ee Y.S., Hyun D.W., Jung B.C. et al. KTK Cardiac Electrophysiology Working Group. Left atrial volume index as a predictor for occurrence of atrial fi brillation after ablation of typical atrial fl utter. J. Cardiol. 2010;56:348–53.O zcan C., Strom J.B., Newell J.B. et al. Incidence and predictors of atrial fi brillation and its impact on long-term survival in patients with supraventricular arrhythmias. Europace. 2014;16:1508–14.O zcan C., Strom J.B., Newell J.B. et al. Incidence and predictors of atrial fi brillation and its impact on long-term survival in patients with supraventricular arrhythmias. Europace. 2014;16:1508–14.B rembilla-Perrot B., Girerd N., Sellal J. M. et al. Risk of atrial fi brillation after atrial fl utter ablation: impact of AF history, gender, and antiarrhythmic drug medication. J. Cardiovasc. Electrophysiol. 2014;25:813–820. DOI: 10.1111/jce.12413.B rembilla-Perrot B., Girerd N., Sellal J. M. et al. Risk of atrial fi brillation after atrial fl utter ablation: impact of AF history, gender, and antiarrhythmic drug medication. J. Cardiovasc. Electrophysiol. 2014;25:813–820. DOI: 10.1111/jce.12413.Ellis K., Wazni O., Marrouche N., Martin D. et al. Incidence of atrial fi brillation post-cavotricuspid isthmus ablation in patients with typical atrial fl utter: left-atrial size as an independent predictor of atrial fi brillation recurrence. J. Cardiovasc. Electrophysiol. 2007;18:799–802.Ellis K., Wazni O., Marrouche N., Martin D. et al. Incidence of atrial fi brillation post-cavotricuspid isthmus ablation in patients with typical atrial fl utter: left-atrial size as an independent predictor of atrial fi brillation recurrence. J. Cardiovasc. Electrophysiol. 2007;18:799–802.Стеклов В.И., Серговенцев А.А., Рзаев Ф.Г. и др. Предикторы фибрилляции предсердий у пациентов с трепетанием предсердий после радиочастотной аблации нижнего перешейка. Вестник аритмологии. 2017;87:23–27.Steklov V.I., Sergoventsev A.A., Rzaev F.G. et al. Predictors of atrial fi brillation in patients with atrial fl utter after radiofrequency ablation of the lower isthmus. Vestnik aritmologii. 2017;87:23–27. (i n Russian)Navarrete A., Conte F., Moran M. et al. Ablation of atrial fi brillation at the time of cavotricuspid isthmus ablation in patients with atrial fl utter without documented atrial fi brillation derives a better longterm benefi t. J. Cardiovasc. Electrophysiol. 2011;22(1):34–8. DOI: 10.1111/j.1540-8167.2010.01845.x.Navarrete A., Conte F., Moran M. et al. Ablation of atrial fi brillation at the time of cavotricuspid isthmus ablation in patients with atrial fl utter without documented atrial fi brillation derives a better longterm benefi t. J. Cardiovasc. Electrophysiol. 2011;22(1):34–8. DOI: 10.1111/j.1540-8167.2010.01845.x.S teinberg J.S., Romanov A., Musat D. et al. Prophylactic pulmonary vein isolation during isthmus ablation for atrial fl utter: the PReVENT AF Study I. Heart Rhythm. 2014;11(9):1567–72. DOI: 10.1016/j.hrthm.2014.05.011.S teinberg J.S., Romanov A., Musat D. et al. Prophylactic pulmonary vein isolation during isthmus ablation for atrial fl utter: the PReVENT AF Study I. Heart Rhythm. 2014;11(9):1567–72. DOI: 10.1016/j.hrthm.2014.05.011.Mohanty S., Natale A., Mohanty P. Pulmonary vein isolation to reduce future risk of atrial fi brillation in patients undergoing typical fl utter ablation: results from a randomized pilot study (REDUCE AF). J. Cardiovasc. Electrophysiol. 2015;26(8):819–25. DOI: 10.1111/jce.12688.Mohanty S., Natale A., Mohanty P. Pulmonary vein isolation to reduce future risk of atrial fi brillation in patients undergoing typical fl utter ablation: results from a randomized pilot study (REDUCE AF). J. Cardiovasc. Electrophysiol. 2015;26(8):819–25. DOI: 10.1111/jce.12688.

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