[Sinus node functions, sinoatrial conduction, atrial conductivity after incipient paroxysms of atrial fibrillation and flutter in patients with ischemic heart disease].
OBJECTIVE
Prediction of the rate of recurrent paroxysms of atrial fibrillation (AF) and flutter (AFl) after the first arrhythmia episode; determination of relevant antiarrhythmic treatment.


METHODS
157 patients with ischemic heart disease (IHD) complicated by new episodes of AF and AFl entered the study. After the initial episode and 1-2 arrhythmia recurrences all the patients have undergone assessment of hemodynamics, atrial conduction of excitation, sinus node function using transesophageal pacing. The patients were divided into two groups: group 1 consisted of 42 patients having no recurrent paroxysms of AF or AFl for at least 6 months; 115 patients of group 2 had at least one episode of recurrent arrhythmia for 6 months after the first paroxysm.


RESULTS
Patients of group 2 vs those of group 1 had a significantly longer first episode, more frequent occurrence of calcinosis of mitral and/or aortic valve, more serious systolic and diastolic dysfunctions and most frequent retrograde atrial excitation conduction after the first paroxysm.


CONCLUSIONS
In detection of only disturbed intraatrial conduction in IHD patients after the first paroxysm of AF and AFl predicted are clinical recurrences of arrhythmia with the recurrence-free period more than 6 months. In retrograde atrial conduction of excitation combined with systolic and diastolic left ventricular dysfunction, sinus node dysfunction prognosis was made of more frequent episodes of AF and AFl.
Olesin
A I
AI
Shabrov
A V
AV
Razumova
T V
TV
Sinenko
V I
VI
Aleksandrov
V S
VS
D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D001282:Atrial Flutter / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D016275:Atrial Function; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000503:physiopathology*; D012008:Recurrence; D012849:Sinoatrial Node / Q000503:physiopathology*
D000889:Anti-Arrhythmia Agents