Рецидиви аритмії тa пізні серцево-судинні ускладнення в пацієнтів із персистентною фібриляцією передсердь після відновлення синусового ритму

Abstract

The aim – to study the role of late recurrences of AF in predicting adverse course of the disease in patients with persistent AF after cardioversion at 9-month follow-up. Materials and methods. The study included 120 patients with documented persistent AF who underwent successful cardioversion during hospitalization. After discharge patients were followed up for 9 months. Demographic and clinical-functional features, data of event monitoring (EV) for 7 days and Holter monitoring (HM ECG), treatment were compared in groups of patients with (n = 15) and without (n = 105) events. Results. During 9-month follow-up, 15 (12.5 %) of 120 patients developed cardiovascular events: death (n = 1), stroke (n = 2), other thromboischemic events (n = 3), myocardial infarction (n = 1), decompensated heart failure (n = 4) and left ventricular ejection fraction (LVEF) reduction 10 % or more (n = 9). Patients with and without events had no significant differences in age, gender, weight, risk factors, HM ECG data and background pathology. Patients with events had a higher risk of CHA2DS2-VASc (p = 0.05), lower LV EF (p = 0.00009), more symptomatic recurrence of AF (p = 0.08), ventricular arrhythmias (p = 0.08) and short-run atrial tachyarrhythmia lasting up to 30 seconds (p = 0.05) according to EM; AF more often turned into permanent form (p = 0.002). Patients with events were more likely to receive digoxin (p = 0.04). Conclusions. The main differences between patients with persistent AF after successful recovery of the sinus rhythm, in which events occurred within 9 months, were: higher score on the scale CHA2DS2-VASc, lower LV EF, more frequent presence of late recurrences of AF, including transition to a permanent form, more frequent short-term paroxysms of atrial tachyarrhythmias during EM after 9 months of observation, as well as the use of digoxin.