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The paper contains comparison of sensitivity and rates of false negative results of transthoracic (TT), transesophageal (TE), and intracardiac (IC) echocardiography (echoCG) during transseptal puncture in the run of the procedure of radiofrequency ablation of atrial fibrillation. In the work fulfilled we analyzed results of 208 echocardiographical intraprocedural investigations conducted with the aim of visualization of interatrial septum (IAS) during transseptal puncture. TT, TE and IC echoCG were carried out in 32, 26, and 150 cases, respectively. Phenomenon of IAS stretching was visualized by TT echoCG in 2 (6%) cases (sensitivity 6.7%). At TE tenting phenomenon was verified in 20 patients (20%) (sensitivity 86.9%). Puncture of IAS was carried out under IC echoCG control in 127 patients. Puncture was made in the center of thin portion of IAS (in the region of fossa ovalis), in its upper and lower portions in 65, 28, and 15.7% of cases, respectively. Sensitivity of IC echoCG was 98.4%. Rate of false positive results reached 92.8, 13.04 and 1.5% for TT, TE and IC echoCG, respectively. At present IC echoCG is most sensitive and safe ultrasound technique for verification of optimal positioning of the system for conduct of transseptal puncture in the region of IAS in comparison with TT and TE echoCG.

The paper contains presentation of complex analysis of quality of life (QL) of 140 patients with Wolff-Parkinson-White (WPW) syndrome before and during one year after radiofrequency catheter ablation (RFCA) of accessory pathways (AP) . Assessment of QL was based on the use of nonspecific and specific questionnaires. Parameters of QL were analyzed in dependence on localization of AP and its electrophysiological properties (concealed, manifested). It was shown that before intervention parameters of QL in patients with WPW syndrome were significantly lower than in the group of clinical comparison (practically healthy persons). Complex study of criteria of QL allows to assert that just after 2 months after RFCA there occurs considerable improvement of the general condition of patients with WPW syndrome. 6 and 12 months after operation complete restoration of both physical and mental working capacity was noted. This is confirmed by absence of significant differences between QL criteria in patients with WPW syndrome and in the group of healthy volunteers.

Primary procedure of radiofrequency ablation (RFA) of chronic atrial fibrillation (AF) using nonfluoroscopic mapping system was carried out in 49 patients (mean age 52.2 +/- 11.3 years, 6 women). Etiology of AF was coronary artery disease, cardiosclerosis after myocarditis, dilated cardiomyopathy in 32, 11 and 2 patients, respectively. AF was idiopathic in 4 patients. History of chronic AF varied from 6 months to 17 years (mean 1.8 years). During follow-up for 14 +/- 5 months total efficacy of RFA was 86%. Redo procedures of endocardial electrophysiological study EPS and RFA were performed in 3 cases because of atypical atrial flutter in 2, 3, and 6 months after initial intervention, and in 1 case because of focal left atrial tachycardia (2 months after initial procedure of EPS and RFA for AF). After repetitive sessions because of atypical atrial flutter and focal left atrial tachycardia efficacy was 98%. There were no complications related to the operations.