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Современные аспекты хирургического лечения больных с фибрилляцией предсердий. Разработка единых критериев для отбора пациентов на проведение радиочастотной абляции

https://doi.org/10.21518/2079-701X-2019-21-58-64

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Аннотация

В статье обсуждаются вопросы, касающиеся лечения больных c персистирующей формой фибрилляции предсердий (ФП), анализируются показания к выполнению, при отсутствии эффекта от медикаментозного лечения, радиочастотной катетерной абляции (РЧА) устьев легочных вен и электрических спиральных волн в предсердиях или роторов, клинические эффекты этой процедуры, оценивается вклад фокусной активности в поддержание персистирующей ФП. Обсуждается вопрос влияния сопутствующей патологии и анатомо-морфологических особенностей сердца на ранние и отдаленные результаты РЧА у пациентов с персистирующей формой ФП. Успех и эффективность хирургического лечения ФП зависят не только от метода и технологии выбранной процедуры, но и от факторов риска рецидива ФП (так называемых предикторов). Радиочастотная абляция, являясь инвазивным хирургическим вмешательством, имеет свой спектр возможных осложнений и высокую экономическую составляющую, что предопределяет необходимость прогнозирования эффективности процедуры, то есть дооперационного определения той группы пациентов, у которых данный вид лечения окажется оправданным, а предполагаемые эффективность и безопасность – выше вероятности осложнений. Изучение этой проблемы и разработка критериев отбора пациентов с ФП позволит с высокой вероятностью предсказывать эффективность оперативного вмешательства, что, в свою очередь, будет способствовать правильному выбору стратегии.

Об авторах

И. А. Либов
Городская клиническая больница имени С.П. Боткина
Россия

 Либов Игорь Аркадьевич, к.м.н., врач-кардиолог

125284, Россия, Москва, 2-й Боткинский пр-д, д. 5



И. М. Майоров
Городская клиническая больница имени С.П. Боткина
Россия

Майоров Игорь Михайлович, к.м.н., врач-кардиохирург

125284, Россия, Москва, 2-й Боткинский пр-д, д. 5



Л. П. Порунова
Городская клиническая больница имени С.П. Боткина
Россия

Порунова Людмила Петровна, врач-кардиолог

125284, Россия, Москва, 2-й Боткинский пр-д, д. 5



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Для цитирования:


Либов И.А., Майоров И.М., Порунова Л.П. Современные аспекты хирургического лечения больных с фибрилляцией предсердий. Разработка единых критериев для отбора пациентов на проведение радиочастотной абляции. Медицинский Совет. 2019;(21):58-64. https://doi.org/10.21518/2079-701X-2019-21-58-64

For citation:


Libov I.A., Mayorov I.M., Porunov L.P. Modern aspects of surgical treatment of patients with atrial fibrillation. Development of uniform criteria for selecting patients for radiofrequency ablation. Meditsinskiy sovet = Medical Council. 2019;(21):58-64. (In Russ.) https://doi.org/10.21518/2079-701X-2019-21-58-64

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ISSN 2079-701X (Print)
ISSN 2658-5790 (Online)