Yu.V. Zinchenko Proarrhythmogenic effects of antiarrhythmic therapy at transesophageal electric cardiac stimulation in the patients with atrial flutter

We performed transesophageal electric cardiac stimulation procedures (TEECS) in order to restore sinus rhythm in 92 patients with non-valvular isolated atrial flutter (AF) on background of CAD (n=75) and
myocardiofibrosis (n=17) with ECG FF interval within 260–279 ms. Arterial hypertension was diagnosed in 67 (72.8 %) patients. Mean arrhythmia anamnesis constituted 4.5 years with mean arrhythmia duration of 47.6±7.5
days. For evaluation of preliminary antiarrhythmic therapy (AAT) influence upon procedure efficacy all patients were divided into two groups: group 1 (n=59) – cardioversion was performed with concomitant AAT; group 2
(n=33) – ААТ wasn’t administered. In group 1 patients were administered amiodaron (49.2 %) and its combinations with other antiarrhythmic agents (AAA) (28.8 %), AAA of class I according to Vaughan-Williams
(13.6 %) and their combinations with atrioventricular conduction blockers (8.5 %). We found significant decrease of TEECS efficacy in group 1 patients with AAT background (86.4 % vs. 100 % in group 2, Р=0.03),
which is explained by proarrhythmogenic effect of AAA: sinus rhythm restoration was through atrial fibrillation periods (Р=0.01), recurrent procedures were needed more often (Р=0.03), higher doses of procainamide were
needed for poststimulation atrial fibrillation treatment (Р<0.05), while TEECS efficacy increased after lowering doses or termination of AAA.

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