[Predictors of Efficacy of Radiofrequency Ablation of Pulmonary Veins Performed During Coronary Bypass Surgery in Patients With Ischemic Heart Disease and Paroxysmal Atrial Fibrillation].

We performed simultaneous coronary artery bypass grafting (CABG) and radiofrequency ablation (RFA) ostia of pulmonary veins in 254 patients (147 men and 107 women) with ischemic heart disease and paroxysmal atrial fibrillation (AF). In-hospital mortality in patients with early recurrence of AF was 8.4%, in patients without recurrence of AF 1.9% (χ2 = 4.65; p = 0.03). The patients were followed-up during 12 months after operation. During follow-up 166 patients (69.5%) had no recurrence of AF without receiving antiarrhythmic drugs (AAP), 33 patients (13.8%) had recurrences of AF, and 40 patients (16.7%) receiving AAD had repeated rare paroxysms of AF. Main predictors of late AF recurrence were age > 65 years, AF duration > 5 years, preoperative atrial effective refractory period < 240 ms, frequency threshold of AF induction < 400 counts/min, anteroposterior left atrial size > 50 mm, glomerular filtration rate < 60 ml/min/1.73 m2. Reverse dynamics of structural, functional and electrophysiological parameters of the heart due to CABG and RFA, use of ß-blockers, angiotensin converting enzyme inhibitors and aldosterone antagonists were associated with the preservation of a stable sinus rhythm. The cardiovascular mortality during 12 months follow-up accounted for 2.1% and 1.2% in groups of patients with and without late recurrences of AF respectively (p > 0.05) to coronary artery bypass grafting surgery and RFA, taking drugs--ß-blockers, angiotensin converting enzyme inhibitors and aldosterone antagonists--were associated with the preservation of a stable sinus rhythm.

[The influence of subclinical thyroid dysfunction on cardiac hemodynamic and electrophysiological parameters in patients with coronary heart disease and paroxysmal atrial fibrillation].

The study included 58 patients with CHD and paroxysmal atrial fibrillation divided into 2 groups depending on thyroid hormone and thyrotropin levels. Group 1 was comprised of 24 patients with subclinical hypothyroidism, group 2 of 18 ones with subclinical hyperthyroidism. Control group consisted of l6 patients with CHD, paroxysmal atrial fibrillation and normal thvroid function. It was shown that patients with CHD, paroxysmal atrial fibrillation and subclinical thyrotoxicosis had T3 and T4 levels 92.6 and 72.5% higher than those with subclinical hypothyroidism. Subclinical thyroid dysfunction was shown to influence hemodynamic isoelectric parameters of the heart. Therapy of paroxysmal atrial fibrillation in CHD patients with subclinical hypothyroidism or hyperthyroidism with simultaneous correction of thyroid function increases the efficacy of anti-arrhythmic therapy up to 50 and 45.9% respectively.