title: [Antithrombotic therapy in patients with atrial flutter before planned cardioversion].
abstract: BACKGROUND
  atrium flutter and fibrillation are the heart rhythm disorders that increase the risk of life-dangerous complications, e.g. cardioembolic stroke, pulmonary embolism. Recommendations for managing patients with atrial fibrillation - atrial flutter, with paroxysm duration over 48 hours, demand anticoagulant therapy. Oral anticoagulants, which are the antagonists of K vitamin (Varpharin) and the new oral anticoagulants (Rivaroxaban), are used during the per-manipulative procedure of patients with atrial flutter before restoring the sinus rhythm with transesophageal cardiac pacing.
  
  
  OBJECTIVE
  the present investigation aims to compare efficiency and safety of Varpharin and Rivaaroxaban in treatment patients with atrial flutter before planned cardioversion with transesophageal heart pacing.
  
  
  METHODS
  Varpharin (control group) - in doses equivalent for reaching the target МНВ - or Rivaroxaban (research group), 20 mg., were prescribed to 42 patients with coronary heart disease, concomitant arterial hypertension, and non-valvular paroxysm of atrial flutter with more than 48-hour duration, divided into two groups. There was held the general clinical, echocardioscopy examination. Thrombotic Risk Factor Assessment was made according to the CHA2DS2-VASc scale, Hemorrhagic Risk Factor Assessment was performed according to the HAS-BLED scale, and clinical symptoms assessment was made according to the EHRA scale. The heart rhythm was restored with the transesophageal heart pacing.
  
  
  RESULTS
  the per-manipulative procedure of the patients of research group (21 days were suggested according to the guidelines) shortened, unlike the patients of control group (the period of target МНВ selection had made 30,76±0,62days), the reduction of the symptoms severity by EHRA was considered in dynamics. According to the results of transesophageal heart pacing, the heart rhythm of 15 research group patients restored, and 6 research group patients had atrial fibrillation. Among the patients of the control group, 6 had their heart rhythm restored, as 10 patients had the atrial fibrillation.
  
  
  CONCLUSIONS
  the use of Rivaroxaban during the per-manipulative procedure before planned cardioversion with transesophageal heart pacing causes shortening of the permanipulative period, reduces the risk of development of symptoms of heart failure, helps to restore the heart rhythm of the patients with atrium flutter.
authors.affiliation: ВИЩИЙ ДЕРЖАВНИЙ НАВЧАЛЬНИЙ ЗАКЛАД УКРАЇНИ "УКРАЇНСЬКА МЕДИЧНА СТОМАТОЛОГІЧНА АКАДЕМІЯ", ПОЛТАВА,УКРАЇНА.
authors.forename: Людмила О
authors.initials: ЛО
authors.lastname: М'якінькова
authors.affiliation: ВИЩИЙ ДЕРЖАВНИЙ НАВЧАЛЬНИЙ ЗАКЛАД УКРАЇНИ "УКРАЇНСЬКА МЕДИЧНА СТОМАТОЛОГІЧНА АКАДЕМІЯ", ПОЛТАВА,УКРАЇНА.
authors.forename: Юрій В
authors.initials: ЮВ
authors.lastname: Тесленко
authors.affiliation: ВИЩИЙ ДЕРЖАВНИЙ НАВЧАЛЬНИЙ ЗАКЛАД УКРАЇНИ "УКРАЇНСЬКА МЕДИЧНА СТОМАТОЛОГІЧНА АКАДЕМІЯ", ПОЛТАВА,УКРАЇНА.
authors.forename: Ганна Л
authors.initials: ГЛ
authors.lastname: Пустовойт
authors.affiliation: ВИЩИЙ ДЕРЖАВНИЙ НАВЧАЛЬНИЙ ЗАКЛАД УКРАЇНИ "УКРАЇНСЬКА МЕДИЧНА СТОМАТОЛОГІЧНА АКАДЕМІЯ", ПОЛТАВА,УКРАЇНА.
authors.forename: Тетяна І
authors.initials: ТІ
authors.lastname: Ярмола
authors.affiliation: ВИЩИЙ ДЕРЖАВНИЙ НАВЧАЛЬНИЙ ЗАКЛАД УКРАЇНИ "УКРАЇНСЬКА МЕДИЧНА СТОМАТОЛОГІЧНА АКАДЕМІЯ", ПОЛТАВА,УКРАЇНА.
authors.forename: Ірина В
authors.initials: ІВ
authors.lastname: Циганенко
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D001282:Atrial Flutter / Q000188:drug therapy* / Q000628:therapy; D003131:Combined Modality Therapy; D004554:Electric Countershock; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069552:Rivaroxaban / Q000627:therapeutic use*; D016896:Treatment Outcome; D014859:Warfarin / Q000627:therapeutic use*
chemical_list: D000925:Anticoagulants; D014859:Warfarin; D000069552:Rivaroxaban
keywords:  anticoagulant therapy ;  thrombotic risk; atrial fibrillation – atrial flutter