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Supraventricular tachyarrhythmias pose a significant challenge in neonates and infants, particularly within the first year of life, where prompt and effective management is crucial. By synthesizing available evidence and clinical experience, this review aims to provide a comprehensive overview of antiarrhythmic therapy in this vulnerable population, with a focus on narrow QRS supraventricular tachyarrhythmias. This review examines the current understanding of supraventricular tachyarrhythmia management and discusses the challenges associated with antiarrhythmic therapy in newborns and infants during the critical first year of life, evaluating the efficacy and safety of various antiarrhythmic agents commonly utilized in this population, including dosing considerations, adverse effects, and strategies for acute management and prophylactic long-term antiarrhythmic treatment.

The article analyzes the case of the development of ventricular tachycardia and type 2 myocardial infarction (MI) in an 80-year-old patient with a history of coronary artery disease, MI and chronic heart failure. In 2020, the patient was diagnosed with ventricular extrasystole and started antiarrhythmic therapy with diethylamino propionylethoxycarbonylaminophenothiazine 150 mg per day and sotalol 160 mg per day. In 2022, the patient had an episode of clinical death due to ventricular tachycardia with successful resuscitation. A diagnosis of non-ST-elevation acute coronary syndrome was made, coronary angiography was performed, which did not reveal significant coronary stenosis. Upon further examination, the dynamics of biomarkers of myocardial necrosis confirmed the diagnosis of acute MI. In the analyzed case, the development of ventricular tachycardia and MI is most likely associated with the intake of diethylaminopropionylethoxycarbonylaminophenothiazine in combination with sotalol, prescribed in the presence of contraindications to their use.

Aim. To evaluate the effectiveness of beta-blockers (BB) in the treatment of idiopathic premature ventricular contractions (PVCs) in children.Material and methods. BBs were prescribed to 27 children with idiopathic PVCs. In 3 (11,1%) patients, side effects (hypotension, bronchial obstruction) was revealed at the beginning of therapy. A total of 24 children were included in the further study (15 boys (62,5%), 9 girls (37,5%). The mean age was 8,3±5,4 years. Data from anamnesis, electrocardiography (ECG), 24-hour ECG monitoring, and echocardiography were analyzed.Results. The 24-hour PVC rate was 33,2±17,7 thousand/day or 26,6±13,2%. In 14 (58,3%) children, we recorded paired PVCs, in 3 (12,5%) — multiform, in 10 (41,7%) — runs of non-sustained VT. There were complaints in 7 (29,2%) children. The follow-up period lasted 369,8±119,1 days. Propranolol was received by 17 (70,8%) patients, metoprolol — by 7 (29,2%). The therapy was effective in 11 (45,8%) patients, while ineffective in 13 (54,2%), among which 5 (20,8%) had an increase in the number of PVCs. The effectiveness of BBs was higher in children under the age of 1 year (p=0,043). Propranolol showed greater efficacy than metoprolol (p=0,047). Less efficiency was observed in female patients and those with pathological heart rate turbulence parameters (p=0,04).Conclusion. The effectiveness of BBs in children with idiopathic PVCs is 45,8%, higher in children aged

Aim. To study the advantages of using a portable electrocardiographic (ECG) monitor in outpatients with paroxysmal atrial fibrillation (AF).Material and methods. We examined 88 patients (26 men, 62 women, mean age, 63 [57;68] years) with paroxysmal AF with an average frequency of arrhythmia episodes of 1,0 [0.3;3.75] per month. Forty three (49%) patients were included in the remote monitoring (RM) group using the ECG Dongle monitor, and 45 (51%) patients were included in the conventional monitoring (CM) group. Patients underwent scheduled examinations 2, 6 and 12 months after the start of therapy. Unscheduled consultations were carried out in case of AF recurrence. Patients from the RM group, using portable cardiac monitor, additionally self-registered ECG 1 time per week and in case of symptoms suggestive of AF. ECG strips were sent to the clinical investigator for analysis.Results. With the help of portable cardiac monitor, 2477 ECG strips were collected and analyzed: 2159 (87,2%) — sinus rhythm, 318 (12,8%) — AF and atypical atrial flutter. Forty four episodes of AF in 3 patients were asymptomatic. In addition, 211 (8,5%) sinus rhythm ECG strips were recorded by 13 patients with symptoms suggestive of AF. In the RM group, 7 (16%) patients were hospitalized due to recurrent AF, while in the CM group, 20 (44%) patients (p=0,004). The total number of emergency hospitalizations was 8 and 29 in the RM and CM groups, respectively. The number of patients who called an ambulance was significantly lower in the RM group: in the CM group, 37 calls for an ambulance were made by 22 patients, while in the RM group — 12 patients made 15 calls (p=0,044). The proportion of calls followed by hospitalization (40 vs 70%, p=0,043) was significantly lower in the RM group.Conclusion. Remote ECG monitoring using the ECG Dongle system is a useful way to monitor patients with paroxysmal AF, which make it possible to register asymptomatic AF episodes, differentiate the causes of palpitations, and significantly reduce the frequency of emergency calls and hospitalizations.

The treatment of atrial fibrillation (AF) remains one of the most difficult tasks in modern cardiology. In 2020, the European Society of Cardiology (ESC), together with the European Association for Cardio-Thoracic Surgery (EACTS), published guidelines for the diagnosis and management of AF, which include several new directives.ESC experts have formulated a novel concept for treatment of AF patients. The first component of treatment ‘A' (Anticoagulation/ Avoid stroke) is anticoagulant therapy in patients with increased risk of thromboembolic events. The second line of treatment ‘B' (Better symptom control) is the control of arrhythmia symptoms, selection of a rhythm control strategy or ventricular rate control. The third direction ‘C' includes cardiovascular risk factors and comorbid conditions management.The most challenging tasks in AF treatment are the control of arrhythmia symptoms. As in the previous version of 2016 guidelines, the latest ones identify 2 following strategies in treatment of AF: rhythm control and ventricular rate control.According to the current ESC/EACTS guidelines (2020), antiarrhythmic therapy continues to be one of the important directions in AF management. Early prescription f antiarrhythmic and anticoagulant agents with an increased risk of thromboembolic events, catheter ablation can not only improve the quality of life, but also the prognosis of patients with AF.

Russian Society of Cardiology (RSC).With the participation of Russian Scientific Society of Clinical Electrophysiology, Arrhythmology and Cardiac Pacing, Russian Association of Cardiovascular Surgeons.Approved by the Scientific and Practical Council of the Russian Ministry of Health.

Atrial fibrillation (AF) is the most common heart rhythm disorder encountered in clinical practice. Each year, the number of patients with AF significantly increases. It is associated with an increase of life expectancy and frequency of cardiovascular pathologies. Treatment of AF remains one of the most difficult tasks of modern cardiology. Currently, only a few antiarrhythmic drugs are available for use in Russia. More and more new attempts are being made to create a universal antiarrhythmic drug with a high level of anti-relapsing efficacy and adverse effects. The accumulated information suggests that the tactics of management of patients with arrhythmias will be intended to improving the new surgical and interventional treatment methods with use of anticoagulants and antiarrhythmic drugs. The multidisciplinary team of specialists on AF treatment should include an expert (cardiologist) in antiarrhythmic drug therapy, an interventional electrophysiologist, and a cardiac surgeon — master the technology of interventional or surgical ablation. Effective interaction of specialists of various levels will improve the results of rhythm control and prevention of complications in patients with AF.

Due to the spectacular progress made in human genomic studies, molecular biology and genetics have become an essential part of modern medicine making it possible to early detect the risk factors and select the personalized treatment. The genetic studies have been widely used in the diagnosis and treatment of arrhythmias. Significant advances in the study of electrophysiological and genetic mechanisms of life-threatening arrhythmias have been achieved through studies of familial conditions with high risk of sudden cardiac death. However, the area of special interest for a practitioner is the identification of mutations associated with atrial fibrillation (AF). The novel methods enable us to study histological, structural, cellular and molecular causes of this arrhythmia. The two main directions of molecular genetic studies of AF are the identification of genetic mutations causing familial atrial fibrillation and the study of different genes polymorphism predisposing to arrhythmia in general population. Gene polymorphism screening helps both identify AF risk factors and predict its evolution from paroxysmal to chronic type. Emerging genetic studies provided explanation for the variable efficacy of antiarrhythmic drugs. It can be assumed that the clinical use of genetic methods will allow accurate and personalized selection of antiarrhythmics. Currently, therapeutic drug monitoring is widely recommended for a number of medications including cytostatics, aminoglycosides, anticonvulsants, and, by some researchers, antiarrhythmic and anticoagulant drugs. Medicine from the very beginning was intended to be personalized, but until recently it was a little more than a myth. The discovery of the human genome makes it possible to choose the most effective treatment with minimal adverse drug reactions for a particular patient.

Supraventricular tachycardia (SVT) is one of the most common arrhythmias. The prevalence of SVT varies widely in different countries and is 2,25 per 1,000 people in the general population. SVT reduce the quality of life of patients, and in some cases can worsen the prognosis. In patients with cardiovascular disease, the risk of SVT increases. Therapy of SVT is selected depending on the stability of hemodynamic and the QRS width. Until now, the treatment of SVT remains an urgent issue of modern cardiology, since despite the high effectiveness of catheter ablation, antiarrhythmic therapy plays an important role.

Aim. Catheter ablation (CA) is an effective approach for rhythm control in atrial fibrillation (AF), however antiarrhythmic therapy (AAT) remains important. There is a lack of data about long-term AAT use after CA. This study evaluates AAT after CA for AF.Material and methods. In 2012-2016, EURObservational Research Programme of Atrial Fibrillation Ablation Long-Term (EORP AFA L-T) registry was conducted, which included 476 Russian patients (57,1% — men; mean age — 57,1±8,7 years). The follow-up after CA was 12 months (available in 81,9% of patients). The use of AAT was evaluated prior to hospitalization, during hospitalization for CA, as well as at 3, 6 and 12 months of follow-up.Results. Prior to CA, 439 (92,2%) patients received AAT During CA, 459 (96,4%) patients were treated with AAT. After CA, AAT was used by 463 (97,3%), 370 (94,8%), and 307 (78,7%) patients at 3, 6 and 12 months of follow-up, respectively. There was no arrhythmia recurrence in 187 (47,9%) subjects. Among these patients, 40 (21,4%) received class IC or III AAT. The peak of AAT use was found for class IC agents within 3 months after CA (P

Aim. Comparison of different treatment tactics – medicated antiarrhythmic therapy (AAT) and radiofrequency ablation (RFA) of elderly and senile pa- tients with relapsing atrial fibrillation (AF) as more severe patients with a burdened comorbid background.Material and methods. The study included 108 patients with paroxysmal and persistent AF who were in hospital and then under outpatient observation for 2 years. Depending on the method of treatment, patients were divided into 2 groups: the group receiving medicated AAT (n=45) and the group treated with RFA (63 patients). Most patients of the 2nd group (n=60) after the RFA received AAT, i.e. so-called hybrid therapy. These groups were comparable in age (mean age 64.9 and 64.7 years, respectively), sex and underlying pathology, comorbid diseases.Results. In patients who received "hybrid" therapy after 2 years of observation, it was more often possible to preserve the sinus rhythm and achieve a reduction in arrhythmia episodes in comparison with the drug group (95.2% and 86.6%, respectively). Quality of life and the frequency of complications of AAT in these groups of patients were comparable.Conclusion: In elderly and senile patients with paroxysmal and persistent atrial fibrillation, RFA and hybrid therapy was more effective for maintaining sinus rhythm compared to drug therapy. After RFA in this category of patients, in most cases, medicated AAT was used. When choosing the tactics of rational AAT in elderly patients, preference should be given to tactics in which it is possible to achieve an improvement in the quality of life.

Aim. To analyze the results of 5-year follow-up of the paroxysmal atrial fibrillation patients (PAF) taking antiarrhythmic therapy (AAT)Material and methods. Patients (n=500) were selected to 11 groups: I — healthy, II — controls, III-XI — PAF taking AAT. The baseline parameters of heart rate variability (HRV) were assessed during 5-year follow-up.Results. Decrease of SDNN does 1,9 times increase the risk of AF development during the first 3 months from preventive AAT start. Decrease of RMSSD does 3,9 times increase the risk of AF during the first 2 weeks, and 1,9 times — 3 months; decrease of Delta X increases the risk of AF 3,9 times during 2 weeks, 2 times — during 3 months, 1,4 times — during 6 months, 1,3 times — during 12 months and 3 years. Increase of Amo does 1,8 times increase the risk of AF during first 3 months. If there was baseline decrease of Delta X and RMSSD, then within 2 weeks the AF paroxysm developed in 7,9% patients, and in 3 months — 15,9% patients. With the decrease of Delta X and RMSSD, in combination with low SDNN, the probability of sinus rhythm retention during 1 year is 51,2%.Conclusion. PAF patients taking preventive AAT demand for ECG assessment of HRV parameters no less than once per 3 months.

T he article focuses on the main debating and unresolved issues on atrial fibrillation patients therapy, e.g. anticoagulation, antiarrhythmic, intervention and surgical tactics. The weaknesses and disadvantages are discussed, of the modern conservative and invasive strategies, as of the modern classification of atrial fibrillation; the issues on optimal rhythm control in atrial fibrillation, and early diagnostics. Each of these problems is related to the range of opportunities for better understanding and management.

Aim. To study a complex approach in observation and medicationmonotherapy with assessment of its effectiveness and safety, with the following antiarrhythmic drugs (AAD): IC class propafenon, III class sotalol, IV class verapamil, — comparing to the controls without AAD, for prevention of atrial fibrillation (AF) recurrent, as atrial tachyarrhythmia (AT) in postoperation period of catheter isolation of the pulmonary veins ostia (PV).Material and methods. The study PRUF is prospective, comparison, open-label, randomized, with control group. Males and females included, at the age ≥25 y., having symptomatic paroxysmal AF without organic pathology of the heart. 243 patients were randomized to 4 groups according the drugs studied and invasive management group with achieved successful isolation of the PV ostia, confirmed during operation. There were no significant differences in baseline characteristics: sex, age, duration of AF, main disease and comorbidities, echocardiography parameters and concomitant therapy. Follow-up lasted for 365 days.Results. PRUF study provided the following results: in group 1 (verapamil) effectiveness after first operation was 65,5% (n=40), in group 2 (propafenon) — 70,96% (n=44), in group 3 (sotalol) — 65% (n=39) and the controls (no AAD) — 65% (n=39), respectively. Main results of the study will be presented in further publications.Conclusion. First time, the assessment of efficacy and safety provided, of different AAD classes for prevention of AF and AT episodes in earlier and later post-operation periods of catheter PV ostia, with implanted subcutaneous cardio monitor for symptomatic and asymptomatic AT, and traditional 24-hour monitoring system by Holter.

In recent years, progress has been made in the study of the natural history of atrial fibrillation (AF) - that, from the stage of having no clinical manifestations, to the final stage, which is an irreversible arrhythmia, is associated with the development of serious cardiovascular complications. Most AF patients steadily progress in persistent or permanent form, but the risk factors and predictors of progression of the arrhythmia is not clearly defined. There is little research done on the effect of long-term antiarrhythmic therapy on the progression of AF. Objective. To evaluate the progression of arrhythmias in patients with arterial hypertension (AH) with paroxysmal AF in the treatment of propafenone (propanorm) compared to treatment with bisoprolol (Concor) in the long-term prospective study. Materials and methods. The study included 62 patients with essential hypertension aged 45 to 63 years. Patients were randomized into 2 groups: 32 patients in group 1 for storing heart rate propafenone took a daily dose of 450 mg, 30 patients in group 2 to control ventricular rate was appointed bisoprolol. Prospective monitoring of patients was carried out from 2011 to 2015, the progression of the arrhythmia was considered: increase in the frequency of paroxysms of arrhythmia in the last 3 months, the appearance of long-term persistent AF episodes or persistent AF. Results. In 14 (44%) patients in group 1 and 20 (67%) - group 2 5 years of observation, it was noted increase in the frequency and duration of AF episodes. The average value of arrhythmia progression into a more stable form of 9.3% per year in patients receiving propafenone, and 11.5% - bisoprolol (p=0.007). Keeping the treatment of sinus rhythm propafenone in a daily dose of 450 mg contributed to a significant reduction of the left atrium anteroposterior size from 43±3 to 36±3 mm (p=0.03). In the treatment with bisoprolol anteroposterior size of the left atrium was not significantly changed and amounted to 44±3 and 43±3 mm respectively. Portability of propafenone antiarrhythmic therapy was comparable with that of bisoprolol. No severe or serious side effects were observed in patients during the long-term prospective study. Conclusion. The five-year propafenone treatment of hypertensive patients with paroxysmal AF can reduce the progression of AF in a more stable form compared with bisoprolol therapy.

Modern approaches to antiarrhythmic anti-relapse therapy of atrial fibrillation are considered. Advantages and disadvantages of the main therapeutic strategies are discussed from the standpoint of evidence-based medicine. The value of strategies of rhythm control, heart rate control and «upstream therapy» in the management of patients with atrial fibrillation is specified. Results of clinical studies on the efficacy and safety of anti-arrhythmic drugs, the search for such new drugs are presented. The authors state, that possibilities of modern drug therapy are limited, development and efficiency of other methods of anti-relapse therapy are low, new groups of drugs are not effective enough or are far from clinical applications. At that the adherence to treatment of patients with atrial fibrillation is unstudied, and its influence on the treatment outcomes, prevention of complications and long-term prognosis are ignored. Authors concluded that in conditions of limited capacity for drug therapy, evaluation of the effect of adherence to treatment in patients with atrial fibrillation, and elaboration on this basis the principles and tools of therapy, taking into account social and personal characteristics, are the most perspective directions of modern arrhythmology.

Data on atrial fibrillation (AF) epidemiology and AF influence on the risk of cardiovascular complications are presented. Principles and tactics of AF therapy are discussed in accordance to evidence based medicine and European society of cardiology Guidelines. Algorithms for choice (on the basis of risk stratification) of different antiarrhythmic drugs and anticoagulants are described. Perspectives in improvement of efficacy and safety of AF therapy are reviewed.

Basic principles of the management of patients with atrial fibrillation (AF) are discussed taking into account recommendations of the European Society of Cardiology (2010). Peculiarities of AF diagnosis, clinical course and severity estimation, approaches to complications prevention and therapy strategy choice in patients with AF (rhythm control or heart rate control) are presented.

Aim. To evaluate effects of angiotensin converting enzyme inhibitor spirapril on efficacy of preventive antiarrhythmic therapy in patients with paroxysmal atrial fibrillation (AF).Material and methods. 40 patients with paroxysmal AF were involved in open-label, cross-over study with periods of antiarrhythmic drug withdrawal. During 3 months all patients received by turns two types of therapy: combination of preventive antiarrhythmic therapy with spirapril 6 mg once daily - (CT group) or preventive antiarrhythmic therapy only (AT group).Results. AF-free intervals to the first and the second AF paroxysms during antiarrhythmic drug withdrawal were comparable ) in AT and CT groups (p=0,4 and p=0,6, respectively, logrank test).Conclusion. Spirapril added to the basic preventive antiarrhythmic therapy during 3 months had no effect on the length of interictal period in paroxysmal AF.

The purpose of this article is to discuss the issues related to the treatment of patients with paroxysmal and persistent atrial fibrillation (AF). The article discusses the indications for patients with radiofrequency catheter (RFC) ablation of the mouths of the pulmonary veins and based on the results of randomized clinical trials analyzed the clinical effects of this procedure, depending on the type of AF. The article discusses the initiation of antiarrhythmic therapy and the duration of its application after RFC.

Aim. To study the changes of plasma levels of NT-proBNP and NT-proANP in patients with persistent atrial fibrillation (AF) treated with various antiarrhythmic drugs.Material and methods. Patients with persistent AF (n=123) aged 39-83 years old were included into the study. The patients were divided into 2 groups: group 1 included patients with arterial hypertension (n=61), group 2 - patients with ischemic heart disease (IHD; n=62). After sinus rhythm restoration the patients were divided into 4 subgroups. Patients of 1A subgroup used propafenone to maintain sinus rhythm during the next 6 months, while patients of 2A subgroup used amiodarone. Patients of 1B and 2B subgroups used bisoprolol to control ventricular rate. Plasma natriuretic peptide levels were evaluated in all patients during the first 3 days after the sinus rhythm restoration and 6 months after.Results. Increased levels of NT-proBNP and NT-proANP in the first days after the sinus rhythm restoration were found in patients of both groups and were associated with the episode of AF. After 6 months of treatment the reduction of NT-proBNP and NT-proANP levels was found in patients of 1A subgroup (NT-proBNP: from 160.5±15.2 pg/ml to 130.1±12.2 pg/ml; NT-proANP: from 15.3±6.4 nmol/L to 11.5±5.3 nmol/L, p

The study was aimed to understand the knowledge level of physicians in primary care for the management of patients with atrial fibrillation (AF) in various clinical situations. The doctors were surveyed on emergency medical treatment of AF, as well as the tactics of treatment of patients with cardiac arrhythmias in addition to a comorbidity. The author analyzed the most common mistakes made by doctors during management of patients with AF and correlation between dynamics of the knowledge level and professional training of doctors.

Constanze Schmidt*, Jana Kisselbach*, Patrick A Schweizer, Hugo A Katus, Dierk ThomasDepartment of Cardiology, Medical University Hospital, Heidelberg, Germany*These authors contributed equally to this workAbstract: Atrial fibrillation (AF) is the most frequently encountered sustained cardiac arrhythmia in clinical practice and a major cause of morbidity and mortality. Effective treatment of AF still remains an unmet medical need. Treatment of AF is based on drug therapy and ablative strategies. Antiarrhythmic drug therapy is limited by a relatively high recurrence rate and proarrhythmic side effects. Catheter ablation suppresses paroxysmal AF in the majority of patients without structural heart disease but is more difficult to achieve in patients with persistent AF or with concomitant cardiac disease. Stroke is a potentially devastating complication of AF, requiring anticoagulation that harbors the risk of bleeding. In search of novel treatment modalities, targeted pharmacological treatment and gene therapy offer the potential for greater selectivity than conventional small-molecule or interventional approaches. This paper summarizes the current understanding of molecular mechanisms underlying AF. Established drug therapy and interventional treatment of AF is reviewed, and emerging clinical and experimental therapeutic approaches are highlighted.Keywords: atrial fibrillation, antiarrhythmic therapy, anticoagulation, catheter ablation, stroke

To investigate antiarrhythmic therapy effectiveness, safety and impact on quality of life (QoL) among patients with symptomatic extrasystolia, a study was performed in 152 individuals, with 140 completing the study. Mean age of the patients was 57 years; 102 patients sufferedfrom chronic coronary heart disease (CHD), 33 - from Grade IIessential arterial hypertension (AH) without CHD. Therapy included propafenone (Propanorm, PRO/ MED.CS Praha a.s.) in the dose of 300-450 mg/d, amiodarone (Cordaron, SANOFIWINTHROPINDUSTRIE), in the initial dose of 600 mg/d, gradually reduced to 200 mg/d, and metoprolol (Egilok, EGIS PHARMACEUTICAL Ltd.) in the dose of 50-100 mg/d. The treatment started in the hospital, followed by out-patient therapy. The follow-up period varied from 12 to 24 months, with mean duration of 18 months. If clinical course improved, antiarrhythmic therapy (AAT) could be stopped, starting again in case of recurrent extrasys-tolia. AAT effectiveness was assessed by Holter ECG monitoring, QoL - by special questionnaires. Assessment took place at baseline, as well as 10-21 days and 12 months after the therapy start. In general, AAT was well tolerated. AAT discontinuation due to adverse effects took place in 11,4 %, 9,5%, and 6,1 % of those receiving amiodarone, propafenone, and metoprolol, respectively. AAT with propafenone, amiodarone and metoprolol was associated with reduction in the extrasystolia number by ≥70 %, 62 %, and 38,2 %, respectively. It was also associated with QoL improvement and reduced anxiety and depression. These changes were maximal and reaching statistical significance in those receiving propafenone and amiodarone, comparing to the metoprolol group. QoL improvement correlated with reduction in extrasystolia number. Therefore, AAT with propafenone, amiodarone, and to a lesser extent, metoprolol, improved QoL in patients with subjective arrhythmia symptoms. The magnitude of this effect depended on antiarrhythmic effectiveness of the medications used. Long-term AAT, in particular, with propafenone and amiodarone, was safe, including patients with chronic CHD.

In total, 1283 patients with coronary heart disease and fist-diagnosed atrial flutter (AFL) episodes were followed up from 1996 to 2007. In all participants, AF was treated with transoesophageal electrocardiostimulation (TOECS). Sinus rhythm was restored in 83,48 %: in 67,3 % without any antiarrhythmic therapy (AAT), and in others - with AAT before TOECS. The best effect was observed in patients receiving amiodarone or its combination with chinidin durules. Only in 2,88 %, AFL or atrial fibrillation remained after TOECS.

Aim. To study clinical effectiveness, safety, and effects on left ventricular (LV) systolic and diastolic function for Class IC and Class III antiarrhythmic medications — propafenone and amiodarone, respectively — in patients with chronic heart failure (CHF), intact ejection fraction (EF), and atrial fibrillation (AF). Material and methods. Out of 227 patients, 198 were followed for 12 months (mean age 54,4±2,1 years). For AF prevention, 138 and 60 participants received propafenone and amiodarone, respectively. The assessed parameters included AF episode incidence, their duration, LV systolic and diastolic function, and therapy safety (incidence of adverse effects, AE) in CHF with intact LV EF. Results. After 12 months of the treatment, propafenone and amiodarone effectiveness for AF prevention was similar — 61,4 % and 63,2 %, respectively. ImprovedLV diastolic filling was associated with increased numbers of Functional Class I CHF patients (+50 %) and reduced hospitalization rates (-72,9). In CHF patients with intact LV EF, propafenone demonstrated a better safety profile than amiodarone: AE incidence was 0,72 % vs. 31,8 %, respectively.Conclusion. In CHF patients with intact LV EF and paroxysmal and/or persistent AF, the Class IC antiarrhythmic medication propafenone demonstrated high antiarrhythmic effectiveness, safety, and beneficial effects onLV diastolic function.