[Use of plasmapheresis in the treatment of drug-resistant cardiac arrhythmias].
OBJECTIVE
To study the therapeutical efficiency of plasmapheresis (PA) in patients with drug-resistant cardiac arrhythmias (CA) and its mechanisms.


METHODS
Discrete PA sessions were carried out in 56 patients with drug-resistant CA: paroxysmal atrial arrhythmia (AA), ventricular and supraventricular premature contractions, supraventricular tachycardia of various etiology. Biochemical blood values, coagulographic parameters, lipid peroxidation (LPO), the spectrum of nonesterified fatty acids (NEFA), the level of medium-sized molecules were determined, ECG monitoring, EchoCG, and left ventricular radioisotope computed tomography were performed before and after a PA session.


RESULTS
PA was effective in 50% of cases. The duration of its effect averaged 3.0 (1.25-5.0) months. PA was more beneficial for patients with IHD, AA with normal left atrial dimensions, and hyperlipidemia. The duration of the effect was significantly higher when antiarrhythmic drug therapy was continued after PA. Due to PA, there were significant decreases in the blood concentrations of cholesterol, medium-sized molecules, malonic dialdehyde (MDA) and in the proportion of polyunsaturated NEFA. The antiarrhythmic effect was associated with the decreases in MDA and NEFA, with a tendency for a reduction in the rate of chemiluminescence.


CONCLUSIONS
PA may be used in the treatment of drug-resistant CA. The most significant mechanism of its antiarrhythmic activity is to recover sensitivity to antiarrhythmics. The intrinsic antiarrhythmic activity may be associated with its effect on NEFA metabolism and LPO; however, its mechanisms await further studies.
Nedostup
A V
AV
Tsaregorodtsev
D A
DA
Ragimov
A A
AA
Solov'eva
I N
IN
Alekseeva
L A
LA
Andrianova
M Iu
MIu
Paliulina
M V
MV
Mil'chakov
V I
VI
Svirshchevskiĭ
E B
EB
Adrianov
S O
SO
Smolianitskiĭ
A Ia
AIa
Egorova
T D
TD
D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001145:Arrhythmias, Cardiac / Q000097:blood / Q000188:drug therapy / Q000378:metabolism / Q000628:therapy*; D005117:Cardiac Complexes, Premature / Q000188:drug therapy / Q000628:therapy; D002784:Cholesterol / Q000097:blood; D003627:Data Interpretation, Statistical; D004351:Drug Resistance; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D006801:Humans; D015227:Lipid Peroxidation; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D010956:Plasmapheresis; D013617:Tachycardia, Supraventricular / Q000188:drug therapy / Q000628:therapy; D013997:Time Factors; D018879:Ventricular Premature Complexes / Q000188:drug therapy / Q000628:therapy
D000889:Anti-Arrhythmia Agents; D005230:Fatty Acids, Nonesterified; D008315:Malondialdehyde; D002784:Cholesterol