[Modern approaches to diagnosis and treatment of tachyarrhythmia at military-medical organizations].

Modem approaches to diagnosis and treatment of tachyarrhythmia at military-medical organizations.. The article describes the principles of differential diagnosis and treatment of tachyarrhythmia. Developed algorithms of diagnostics and treatment of cardiac arrhythmias in the military-medical institutions. The algorithm relief hemodynamically stable rhythmic tachycardia. The results of interventional -treatment in 462 patients with tachyarrhythmia heart. The high efficacy and safety of radiofrequency ablation technique in patients with tachyarrhythmia heart.

[A new light on professional fitness expertise of patients with highly curable arrhythmia after hi-tech methods of treatment].

The peculiarities of a clinical course, results of pharmacological and interventional treatment in 447 patients with noncoronary cardiac arrhythmias were analyzed. A definition highly curable cardiac arrhythmia is introduced. The high efficiency and safety of the method of radiofrequency ablation in patients with highly curable cardiac arrhythmias that allows soldiers to leave the military service, as well as to enter military service under the contract. Proposed implementation of the control medical examination to conduct endocardial electrophysiological study and the subsequent medical examination to determine the category of fitness for military service not earlier than 6 months after surgery.

[State-of-the-art and prospects of high-tech medical aid to patients with cardiac arrhythmia based at military medical facilities].

Analysis of provision of high-tech medical aid to patients with cardiac arrhythmia based at military medical facilities showed that the available means and workforce are sufficient for the purpose. In order to facilitate access to high-tech medical aid it is necessary to equip arrhythmologic departments with up-to-date-instruments and set up cabinets of electrocardiostimulation in regional (naval) hospitals for implantation of temporary and permanent pacemakers. A program is pending for education (primary specialization) and advanced training of specialists in clinical cardiac electrophysiology, interventional and surgical arrhythmology.

[Radiofrequency ablation of focal atrial tachycardia from the right atrial appendage].

The authors report a case of elimination of permanently recurring focal atrial tachycardia affecting the right atrial appendage by radiofrequency catheter ablation in a 20 year old serviceman.

[Innovative methods of ventricular arrhythmia treatment].

The authors summarized the experience of the use of the stimulus and the activation mapping under fluoroscopic control to search for sources of ventricular ectopic followed by radio-frequency effects on the vulnerable zone arrhythmias. The authors presented an algorithm for finding a pathological focus on the basis of an evaluation of the surface electrocardiogram, followed by sequential endocardial mapping. The results of radiofrequency ablation of ventricular arrhythmia in different localization of the source are presented. The authors generalized and systematized the experience detection and cure of ventricular ectopy in 65 patients. The regularities of changes in the ventricular complex according to surface electrocardiogram in certain localizations of ectopic focus are revealed. Effectiveness of the operation of radiofrequency ablation with ventricular arrhythmias was about 90%, which is generally consistent with data from other clinics. Complications requiring additional interventions were not. Highlight the work areas of the endocardium, analysed the causes of inefficient operations and poor results. Alternative methods of destruction of the endocardium in complex localization of ectopic focus are suggested.

[Evaluation of risk factors for atrial fibrillation in patients with atrial flutter after radiofrequency ablation of cavotricuspid isthmus].

The author researched risk factors for atrial fibrillation in 93 patients with atrial flutter after radiofrequency ablation of cavotricuspid isthmus. Effectiveness of radiofrequency ablation of the inferior isthmus was 93.5%. Before operation in 10% patients from the group of patients without atrial fibrillation, in postoperative period developed atrial fibrillation. Factors for this arrhythmia include elderly age, low contractility of the aortic ventricle of heart, dilation of the left atrium, chronicity and rate of arterial hypertension. In group of patients with atrial fibrillation in pre- and postoperative period this arrhythmia developed in 73.9% of patients. Risk factors for atrial fibrillation include elderly age, time duration of arrhythmic anamnesis and chronicity and rate of arterial hypertension.

[About military medical examination of patients with paroxysmal supraventricular reciprocating tachycardia].

140 patients with paroxysmal supraventricular reciprocating tachycardia were treated with the help of radio frequency ablation; results of treatment were analyzed. First group consisted of 76 patients with atrioventricular nodal reentrant tachycardia, second group--64 patients with atrioventricular reentrant tachycardia accompanied with WPW syndrome and preexcitation syndrome. In first group the operation ended up with success in 94.7%, in the second group--90.6%, after the second operation--100% and 96.1% relatively. Different complications in patients from the first group occured in 3.9%, in the second group--in 6.3%. Taking into account high effectivennes and safety of radio frequency ablation, it is recommended to reconsider principals of categorisation of fitness for service among conscripts and servicemen doing call-up and under the contract military service and also citizens, entering military educational institutions.

[Electrical stimulation of the heart: history, current trends and prospects].

Part 1 of this review is devoted to the history of development of temporary and continuous electric stimulation (ES) of the heart. Up-to-date concepts of bradyarrhythmia are considered along with the most important techniques for its management with the use of two-chamber and frequency-adaptive systems. Algorithms for the choice of optimal ES regimes taking account of the type of bradyarrhythmia are discussed. Current concepts of physiological ES of the heart are considered. The authors describe their own experience with the application of ES of the heart.

[Resistant hypercholesteremia in clinical practice: new insight into the causes and methods of treatment].

Coronary heart disease and other diseases caused by atherosclerosis, take first place among the causes of adult mortality. Leading role in the development of atherosclerosis belongs to violations of cholesterol metabolism. Reducing mortality from ischemic heart disease primarily associated with adequate correction of the lipid metabolism. The research of the possible causes and correction of resistant hypercholesterolemia is done. Determined that some patients with resistant to statins hypercholesteremia and normal or elevated levels of hormones T3 and T4 in the blood have isolated symptoms of hypothyroidism, which may be a manifestation of reducing tissue sensitivity to thyroid hormones. Adding to the statins levothyroxine in daily doses of 25-50 mkg have additional cholesterol reducing action, allowing to achieve target levels of lipoprotein in blood in patients. The use of levothyroxine in low doses in combination with statins is highly effective and economically justified.

[A study of quality of life of cardiological patients].

The main methods for evaluation of medical aspects of quality of life (QL) are discussed in the article. Special attention is paid to investigation of QL in patients with chronic heart diseases. Modern methods of surgical treatment such as myocardial revascularization, radiofrequency ablation, and pacemaker implantation allow for substantial improvement in QL.