medvisМедицинская визуализацияMedical Visualization1607-07632408-9516RDS-Media Ltd.10.24835/1607-0763-1162medvis-1162Research ArticleСЕРДЦЕ И СОСУДЫHEART AND VESSELSВлияние индексируемого объема левого предсердия на эффективность торакоскопического лечения фибрилляции предсердийInfluence of Left Atrium Volume Index on effectiveness of Thoracoscopic Ablation in the Treatment of Atrial Fibrillationhttps://orcid.org/0000-0003-1791-9163РевишвилиА. Ш.RevishviliA. Sh.

Ревишвили Амиран Шотаевич – академик РАН, доктор мед. наук, профессор, директор

117997 Москва, ул. Большая Серпуховская, д. 27

Amiran Sh. Revishvili – Academician of the Russian Academy of Science, Doct. of Sci. (Med.), Professor, Director 

27, Bol'shaya Serpukhovskaia str., Moscow, 117997

vishnevskogo@ixv.ruhttps://orcid.org/0000-0001-8231-6866КадыроваМ.KadirovaM.

Кадырова Мадина – канд. мед. наук, заведующая отделением ультразвуковой диагностики

117997 Москва, ул. Большая Серпуховская, д. 27

Madina Kadirova – Cand. of Sci. (Med.), Head of the Department of Ultrasound diagnostics 

27, Bol'shaya Serpukhovskaia str., Moscow, 117997

kadirova@list.ruhttps://orcid.org/0000-0003-1395-2951ПоповВ. А.PopovV. A.

Попов Вадим Анатольевич – доктор мед. наук, профессор, руководитель отдела сердечно-сосудистой хирургии

117997 Москва, ул. Большая Серпуховская, д. 27

Vadim A. Popov – Doct. of Sci. (Med.), Professor, Head of the Department of Cardiovascular Surger

27, Bol'shaya Serpukhovskaia str., Moscow, 117997

drvapopov@gmail.comhttps://orcid.org/0000-0002-1572-3178МалышенкоЕ. С.MalishenkoE. S.

Малышенко Егор Сергеевич – научный сотрудник отделения кардиохирургии

117997 Москва, ул. Большая Серпуховская, д. 27

Egor S. Malishenko – Research Officer, cardiovascular surgery of the Department of Cardiac Surgery 

27, Bol'shaya Serpukhovskaia str., Moscow, 117997

malyshenkoegor@gmail.comhttps://orcid.org/0000-0002-9357-0998КармазановскийГ. Г.KarmazanovskyG. G.

Кармазановский Григорий Григорьевич – академик РАН, доктор мед. наук, профессор, заведующий отделом рентгенологии и магнитно-резонансных исследований

117997 Москва, ул. Большая Серпуховская, д. 27

Grygory G. Karmazanovsky – Academician of the Russiаn Асаdemy of Sсienсes, Doсt. of Sсi. (Med.), Professor, Heаd of the Rаdiology Depаrtment

27, Bol'shaya Serpukhovskaia str., Moscow, 117997

karmazanovsky@ixv.ruhttps://orcid.org/0000-0001-5837-7255СтребковаЕ. Д.StrebkovaE. D.

Стребкова Елизавета Дмитриевна – аспирант по специальности “сердечно-сосудистая хирургия”

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1

Elizaveta D. Strebkova – postgraduate student in cardiovascular surgery

2/1 bld. 1, Barrikadnaya str., Moscow 125993

elizabeth.strebkova@yandex.ruhttps://orcid.org/0000-0001-7683-3672ШироковВ. С.ShirokovV. S.

Широков Вадим Сергеевич – врач-рентгенолог отделения рентгенологии и магнитно-резонансных исследований

117997 Москва, ул. Большая Серпуховская, д. 27

Vadim S. Shirokov – radiologist of the Department of Radiology and Magnetic Resonance Research 

27, Bol'shaya Serpukhovskaia str., Moscow, 117997

https://orcid.org/0000-0001-9160-6531НовиковМ. А.NovikovM. A.

Новиков Максим Андреевич – врач сердечно-сосудистый хирург отделения кардиохиргии

117997 Москва, ул. Большая Серпуховская, д. 27

Maxim A. Novikov – cardiovascular surgery of the Department of Cardiac Surgery 

27, Bol'shaya Serpukhovskaia str., Moscow, 117997

https://orcid.org/0000-0002-9409-5164ЯловаЕ. В.YalovaE. V.

Ялова Евгения Владиславовна – ординатор по специальности “ультразвуковая диагностика”

117997 Москва, ул. Большая Серпуховская, д. 27

Eugenia V. Yalova – resident in ultrasound diagnostics

27, Bol'shaya Serpukhovskaia str., Moscow, 117997

https://orcid.org/0000-0002-9280-9063ТаймасоваИ. А.TaimasovaI.  A.

Таймасова Ирина Азатовна – врач сердечно-сосудистый хирург аритмологического центра

117997 Москва, ул. Большая Серпуховская, д. 27

Irina A. Taimasova – cardiovascular surgery of Arrhythmological Сenter 

27, Bol'shaya Serpukhovskaia str., Moscow, 117997

ФГБУ “Национальный медицинский исследовательский центр хирургии им. А.В. Вишневского” Минздрава РоссииРоссияA.V. Vishnevsky National Medical Research Center of Surgery of the Ministry of Healthcare of the Russian FederationRussian FederationФГБОУ ДПО “Российская медицинская академия непрерывного профессионального образования” Минздрава РоссииРоссияRussian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian FederationRussian Federation2022050820222632233Copyright © Ревишвили А.Ш., Кадырова М., Попов В.А., Малышенко Е.С., Кармазановский Г.Г., Стребкова Е.Д., Широков В.С., Новиков М.А., Ялова Е.В., Таймасова И.А., 20222022Ревишвили А.Ш., Кадырова М., Попов В.А., Малышенко Е.С., Кармазановский Г.Г., Стребкова Е.Д., Широков В.С., Новиков М.А., Ялова Е.В., Таймасова И.А.Revishvili A.S., Kadirova M., Popov V.A., Malishenko E.S., Karmazanovsky G.G., Strebkova E.D., Shirokov V.S., Novikov M.A., Yalova E.V., Taimasova I.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medvis.rdsmedia.ru/jour/article/view/1162Цель исследования

Цель исследования: установить влияние индексируемого объема левого предсердия (LAVI) на эффективность торакоскопической аблации фибрилляции предсердий (ФП) (ТА ФП) и определить факторы риска развития наджелудочковых нарушений ритма в отдаленном периоде наблюдения.

Материал и методы

Материал и методы. Проведено проспективное когортное исследование 121 больного с ФП (с 2018 по 2021 г.), которым была выполнена ТА ФП. Пациенты были разделены на две группы: в I группу были включены пациенты с увеличенным LAVI, во II группу – пациенты с нормальным LAVI менее 34 мл/м2.

Результаты исследования

Результаты исследования. По данным эхокардиографии средний показатель LAVI составил 45,48 ± 9,3 мл/м2 и 28,59 ± 4,13 мл/м2 в I и II группах соответственно (p = 0,012). Среднее значение ФВ ЛЖ по Тейхольцу в I группе было 61,62 ± 7,041%, во II группе 63,57 ± 6,16% (p = 0,8). Корреляционный анализ по Спирмену показал взаимосвязь между LAVI и ФВ ЛЖ как до операции, так и в отдаленном периоде наблюдения, что согласуется с данными мировой литературы о вкладе ЛП в работу ЛЖ. Согласно нашему исследованию, только LAVI >34 мл/м2 является фактором риска развития аритмии после ТА ФП. В группе I эффективность ТА ФП составила 77,8%, что существенно ниже показателей восстановления синусового ритма по сравнению со II группой – 88,9%. Через 3 мес после операции потребовалось выполнение 20 (17%) дополнительных катетерных аблаций, преимущественно у пациентов I группы.

Заключение

Заключение. Данные нашего исследования показали, что увеличение LAVI достоверно снижает эффективность ТА ФП в отдаленном периоде на 11,1% по сравнению со II группой при LAVI < 34 мл/м2. Полученные результаты согласуются с данными ранее представленных работ.

Research objective

Research objective: establish the impact of Left Atrium Volume Index (LAVI) on on effectiveness of Thoracoscopic Ablation (TSA) in the Treatment of Atrial Fibrillation (AF) and define the risk factors for manifestation of supraventricular arrhythmias in the long-term follow-up results

Methods

Methods. Prospective cohort study of 121 patients with AF (from 2018 to 2021) who performed TSA. The patients were divided into two groups: patients with increased LAVI (group I), patients with normal LAVI less than 34 ml/m2 (group II).

Results

Results. According to echocardiography, the mean LAVI was 45.48 ± 9.3 ml/m2 and 28.59 ± 4.13 ml/m2 in groups I and II, respectively (p = 0.012). The mean value of left ventricular ejection fraction (LVEF) according to Teicholz in group I was 61.62 ± 7.041%, in group II 63.57 ± 6.16% (p = 0.8). Spearman's сorrelation analysis showed the relationship between LAVI and LVEF before surgery and in the long-term follow-up period, that is agreed with world literature data about contribution left atrial (LA) to left ventricular (LV) function. According to our study, only LAVI < 34 ml/m2 is a risk factor for arrhythmia after TSA. Effectiveness TSA in I group was 77.8%, that is lower than the II group – 88.9%. 3 months after TSA, 20 (17%) patients were required catheter ablations (CA), mainly in I group.

Conclusions

Conclusions. Research results showed that an increase in LAVI significantly reduces the effectiveness of TSA in the long-term period by 11.1% compared with LAVI < 34 ml/m2. That are conform with other data of previously submitted works.

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The authors declare that there are no conflicts of interest present.