Abstract
The article presents the results of treatment and scientific activities of the Department of Surgical Treatment of Tachyarrhythmia for the last year as well as results of research outcomes implementation into clinical practice. The main objective of the department is the radical elimination of atrial fibrillation during operations with cardiopulmonary bypass, both in the case of isolated course, and in combination with acquired heart defects, as well as improving the methods of preoperative and postoperative examination of patients with atrial fibrillation and flutter. In the reporting year, 1324 patients were treated, with total mortality 0.2%. The number of surgeries increased by 10.43% compared to previous year and amounted to 931 operations, of which 51 operations with cardiopulmonary bypass. The results of surgical treatment of patients with various forms of atrial fibrillation are presented. To increase efficiency of treatment of patients with long persistent atrial fibrillation, it would be reasonable to perform Labyrinth 3B procedure with cardiopulmonary bypass. Special attention was paid to the topical diagnosis of macroreentry tachycardias, which were studied using a system of non-invasive electrocardiographic mapping. Also with non-invasive surface electrophysiological mapping a continuing scientific study was connected aimed at increasing the effectiveness of cardiac resynchronization therapy among patients with chronic heart failure. A great contribution to the surgical activity of the department was made by patients with electrode endocarditis who underwent removal of the endocardial stimulation system in the open heart with simultaneous evaluation of the tricuspid valve function and making decision on the valve-saving or valve-substituting technique. Much attention is paid to the development of diagnostic algorithms and approaches to the treatment of genetically determined ventricular arrhythmias.
References
- Kirchhof P., Benussi S., Kotecha D., Ahlsson A., Atar D., Casadei B. et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur. J. Cardiothorac. Surg. 2016; 50 (5): e1–88. DOI: 10.1093/ejcts/ezw313
- Lim H.S., Zellerhoff S., Derval N., Denis A., Yamashita S., Berte B. et al. Noninvasive mapping to guide atrial fibrillation ablation. Card. Electrophysiol. Clin. 2015; 7 (1): 89–98. DOI: 10.1016/j.ccep.2014.11.004
- Ageev F.Т., Danielyan М.О., Mareev V.Tu., Belenkov Yu.N. Patients with chronic heart failure in the Russian outpatient practice: features of the contingent, diagnosis and treatment (according to the study EPOKHA-О-KhSN). Russian Heart Failure Journal. 2004; 5 (1): 4–7 (in Russ.).
- Cleland J.G., Freemantle N., Erdmann E., Gras D., Kappenberger L., Tavazzi L., Daubert J.C. Long-term mortality with cardiac resynchronization therapy in the Cardiac Resynchronization-Heart Failure (CARE-HF) trial. Eur. J. Heart Fail. 2012; 14 (6): 628–34. DOI: 10.1093/eurjhf/hfs055
- Chung E.S., Leon A.R., Tavazzi L., Sun J.P., Nihoyannopoulos P., Merlino J. et al. Results of the Predictors of Response to CRT (PROSPECT) trial. Circulation. 2008; 117 (20): 2608–16. DOI: 10.1161/ CIRCULATIONAHA.107.743120
- Berger T., Pfeifer B., Hanser F.F., Hintringer F., Fischer G., Netzer M. et al. Single-beat noninvasive imaging of ventricular endocardial and epicardial activation in patients undergoing CRT. PLoS One. 2011; 6 (1): e16255. DOI: 10.1371/journal.pone.0016255
- Dawood M.Y., Cheema F.H., Ghoreishi M., Foster N.W., Villanueva R.M., Salenger R. et al. Contemporary outcomes of operations for tricuspid valve infective endocarditis. Ann. Thorac. Surg. 2015; 99 (2): 539–46. DOI: 10.1016/j.athoracsur.2014.08.069
- Gottardi R., Bialy J., Devyatko E., Tschernich H., Czerny M., Wolner E., Seitelberger R. Midterm followup of tricuspid valve reconstruction due to active infective endocarditis. Ann. Thorac. Surg. 2007; 84 (6): 1943–8. DOI: 10.1016/j.athoracsur.2007.04.116
- Hosseini S., Rezaei Y., Mazaheri T., Almasi N., Babaei T., Mestres C.A. Tricuspid valve repair for infective endocarditis with periannular involvement: complete valve reconstruction. J. Heart Valve Dis. 2016; 25 (6): 730–8.
- Cox J.L., Shuessler R.B., Boineau J.P. The development of the Maze procedure for the treatment atrial fibrillation. Semin. Thorac. Cardiovasc. Surg. 2000; 12 (1): 2–14. DOI: 10.1016/S1043-0679(00)70010-4
- Albаge A., Pеterffy M., K_llner G. The biatrial cryomaze procedure for treatment of atrial fibrillation: a single-center experience. Scand. Cardiovasc. J. 2011; 45 (2): 112–9. DOI: 10.3109/14017431.2010.547595
- Robertson J.O., Cuculich P.S., Saint L.L., Schuessler R.B., Moon M.R., Lawton J. et al. Predictors and risk of pacemaker implantation after the Cox-Maze IV procedure. Ann. Thorac. Surg. 2013; 95 (6): 2015–20. DOI: 10.1016/j.athoracsur.2013.03.064
- Lyubkina E.V., Serguladze S.Yu., Mikhaylichenko S.I., Kotanova E.S. Successful elimination of ectopic form of atrial fibrillation from the superior vena cava. Annaly Aritmologii (Annals of Arrhythmology). 2018; 15 (3): 181–4 (in Russ.). DOI: 10.15275/annaritmol.2018.3.6
- Bockeria L.A., Serguladze S.Yu., Kvasha B.I., Khinchagov D.Yа. The case of successful elimination of atrial fibrillation using criomodification of Cox Maze procedure after ineffective thoracoscopic pulmonary vein isolation and radiofrequency ablation of the cavatricuspidal isthmus. Annaly Aritmologii (Annals of Arrhythmology). 2018; 15 (2): 98–102 (in Russ.). DOI: 10.15275/annaritmol.2018.2.4
- Magomedova S.M., Sopov O.V., Lomidze N.N., Pronicheva I.V., Kotanova E.S., Serguladze S.Yu. The role of non-invasive surface electrocardiographic mapping in optimization of сardioresynchronizing devices functioning in patients with chronic heart failure. Annaly Aritmologii (Annals of Arrhythmology). 2017; 14 (4): 199–210 (in Russ.). DOI: 10.15275/annaritmol.2017.4.3
- Curcio A., Mazzanti A., Bloise R., Monteforte N., Indolfi C., Priori S.G., Napolitano C. Clinical presentation and outcome of Brugada syndrome diagnosed with the new 2013 criteria. J. Cardiovasc. Electrophysiol. 2016; 27 (8): 937–43. DOI: 10.1111/jce.12997
- Kapplinger J.D., Tester D.J., Alders M., Benito B., Berthet M., Brugada J. et al. An international compendium of mutations in the SCN5A-encoded cardiac sodium channel in patients referred for Brugada syndrome genetic testing. Heart Rhythm. 2010; 7 (1): 33–46. DOI: 10.1016/j.hrthm.2009.09.069
- Bockeria L.A., Pronicheva I.V., Serguladze S.Yu., Kvasha B.I., Kotanova E.S. Brugada syndrome and cardiac sodium channelopathy overlap syndromes: different faces of SCN5A mutations. Annaly Aritmologii (Annals of Arrhythmology). 2018; 15 (1): 40–54 (in Russ.). DOI: 10.15275/annaritmol.2018.1.5
- Serguladze S.Yu., Sopov O.V., Pronicheva I.V. Report on research and practice and development prospects department of surgical treatment of tachyarrhythmia's 2017 year. The Bulletin of Bakoulev Center for Cardiovascular Surgery. Cardiovascular Diseases. 2018; 19 (4): 580–9 (in Russ.). DOI: 10.24022/1810-0694-2018-19-4-580-589
- Ramanathan C., Ghanem R.N., Jia P., Ryu K., Rudy Y. Noninvasive electrocardiographic imaging for cardiac electrophysiology and arrhythmia. Nat. Med. 2004; 10 (4): 422–8. DOI: 10.1038/nm1011
- Wang Y., Schuessler R.B., Damiano R.J., Woodard P.K., Rudy Y. Noninvasive electrocardiographic imaging (ECGI) of scar-related atypical atrial flutter. Heart Rhythm. 2007; 4 (12): 1565–7. DOI: 10.1016/ j.hrthm.2007.08.019
- Clayton R.H., Nash M.P. Analysis of cardiac fibrillation using phase mapping. Card. Electrophysiol. Clin. 2015; 7 (1): 49–58. DOI: 10.1016/j.ccep.2014.11.011
- Vijayakumar R., Vasireddi S.K., Cuculich P.S., Faddis M.N., Rudy Y. Methodology considerations in phase mapping of human cardiac arrhythmias. Circ. Arrhythm. Electrophysiol. 2016; 9 (11): e004409. DOI: 10.1161/CIRCEP.116.004409
- Salinet J.L., Schlindwein F.S., Stafford P.A., Almeida T.P., Li X., Vanheusden F.J. et al. Propagation of meandering rotors surrounded by areas of high dominant frequency in persistent atrial fibrillation. Heart Rhythm. 2017; 14 (9): 1269–78. DOI: 10.1016/j.hrthm.2017.04.031
- Kuklik P., Zeemering S., Maesen B., Maessen J., Crijns H.J., Verheule S. et al. Reconstruction of instantaneous phase of unipolar atrial contact electrogram using a concept of sinusoidal recomposition and Hilbert transform. IEEE Trans. Biomed. Eng. 2015; 62 (1): 296–302. DOI: 10.1109/TBME.2014.2350029
- Priori S.G., Blomström-Lundqvist C., Mazzanti A., Blom N., Borggrefe M., Camm J. et al. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Eur. Heart J. 2015; 36 (41): 2793–867. DOI: 10.1093/eurheartj/ehv316
- Gottschalk B.H., Garcia-Niebla J., Anselm D.D., Jaidka A., De Luna A.B., Baranchuk A. New methodologies for measuring Brugada ECG patterns cannot differentiate the ECG pattern of Brugada syndrome from Brugada phenocopy. J. Electrocardiol. 2016, 49 (2): 187–91. DOI: 10.1016/j.jelectrocard.2015.12.011
About the authors
-
Sergey Yu. Serguladze, Dr. Med. Sc., Senior Researcher, Head of Department, orcid.org/0000-0001-7233-3611
-
Irena V. Pronicheva, Cand. Med. Sc., Senior Researcher, orcid.org/0000-0003-2669-2474
