88 results on '"Ardashev AV"'
Search Results
2. Atrial Fibrillation and Mortality: Prognostic Factors and Direction of Prevention
- Author
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Ardashev Av, Yu. N. Belenkov, M Ch Matsiukevich, and V A Snezhitskiy
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medicine.medical_specialty ,medicine.medical_treatment ,Treatment outcome ,MEDLINE ,Catheter ablation ,Rhythm control ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Text mining ,Internal medicine ,Atrial Fibrillation ,Humans ,Medicine ,Clinical significance ,030212 general & internal medicine ,Heart Failure ,business.industry ,Atrial fibrillation ,Prognosis ,medicine.disease ,Treatment Outcome ,Heart failure ,Catheter Ablation ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
This review focuses on major causes and risk factors for death of patients with atrial fibrillation (AF). The authors analyzed current therapeutic strategies for managing patients with AF with respect of their effects on prediction and mortality. Special attention is paid to the strategy of rhythm control and the clinical significance of catheter ablation in the treatment of patients with AF and heart failure.
- Published
- 2021
3. Recommendations for the management of COVID 19 patients regarding proarrhythmic effects of some current treatments, specifically if these patients suffer from arrhythmias, and for those receiving antiarrhythmic therapy
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Riccardo Cappato, Ricardo Speranza, Marina Yakovleva, Oscar Oseroff, E G Zhelyakov, Sergey A Sayganov, V A Snezhitskiy, Aras Puodziukynas, Symbat Abzalieva, Ludmila Kolotsey, Luca Santini, Yury Karpenko, Ardashev Av, Rodolfo Sansalone, Yury Belenkov, and Sergey Kanorskii
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2019-20 coronavirus outbreak ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,SARS-CoV-2 ,business.industry ,Conduction disorders ,Pneumonia, Viral ,MEDLINE ,COVID-19 ,Arrhythmias, Cardiac ,Primary care ,COVID-19 Drug Treatment ,Heart Rhythm ,Betacoronavirus ,Humans ,Medicine ,Coronavirus Infections ,Cardiology and Cardiovascular Medicine ,business ,Adverse effect ,Intensive care medicine ,Anti-Arrhythmia Agents ,Pandemics - Abstract
Recommendation provides information to employees of medical departments at any level and primarily primary care about the possible proarrhythmic and adverse effects of drugs used for the treatment of COVID-19 patients and the features of therapy for COVID-19 patients with heart rhythm and conduction disorders receiving permanent antiarrhythmic therapy.
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- 2020
4. Use of Statins, Anticoagulants, Antiaggregants and Antiarrhythmic Drugs in Patients With COVID-19. The Agreed Experts’ Position of Russian Society of Cardiology, Eurasian Association of Therapists, National Society on Atherothrombosis, Societies of Experts in Urgent Cardiology, Eurasian Arrhythmology Association
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N P Mitkovskaya, A O Konradi, Komarov Al, E I Tarlovskaya, Ye V Shlyakhto, V A Snezhitskiy, S V Malchikova, A I Chesnikova, L V Kolotsey, M M Petrova, A B Sugraliyev, V V Skibitsky, A G Arutyunov, N. A. Koziolova, Ya A Orlova, Tereshchenko Sn, Kropacheva Es, G P Arutyunov, I. V. Fomin, Yu N Belenkov, Panchenko Ep, I. S. Yavelov, Ardashev Av, I I Shaposhnik, N Yu Grigorieva, G A Dzhunusbekova, S G Kanorskii, A P Rebrov, Hamayak Sisakian, E G Zhelyakov, and O. M. Drapkina
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medicine.medical_specialty ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,Heart rhythm disorders ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Pneumonia, Viral ,Cardiology ,MEDLINE ,030204 cardiovascular system & hematology ,Russia ,Betacoronavirus ,03 medical and health sciences ,0302 clinical medicine ,Antithrombotic ,Humans ,Medicine ,In patient ,030212 general & internal medicine ,Intensive care medicine ,Pandemics ,Societies, Medical ,SARS-CoV-2 ,business.industry ,Anticoagulants ,COVID-19 ,COVID-19 Drug Treatment ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,Coronavirus Infections ,Cardiology and Cardiovascular Medicine ,business ,Anti-Arrhythmia Agents - Abstract
This article discusses relevant aspects in the treatment of patients with COVID-19. Up-to-date information about principles for administration of statins, antithrombotics, and antiarrhythmics is presented. The authors addressed in detail specific features of reversing heart rhythm disorders in patients with coronavirus infection and the interaction of antiarrhythmic and antiviral drugs. Recommendations are provided for outpatient and inpatient antithrombotic therapy for patients with COVID-19. Issues of antithrombotic and antiviral drug interaction are discussed.
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- 2020
5. Update of the Diagnostic Criteria of J-Wave Syndrome: New Concepts and Their Relevance to Cardiology Practice (According to Materials of J-Wave Syndromes Expert Consensus Conference Report: Emerging Concepts and Gaps in Knowledge (2016)
- Author
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N V Shpak, Yu N Belenkov, L U Martyanova, V A Kuznetsov, T P Gizatulina, V A Snezhitskiy, and Ardashev Av
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Standardization ,J wave syndrome ,business.industry ,Management science ,MEDLINE ,Expert consensus ,030204 cardiovascular system & hematology ,medicine.disease ,Terminology ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Relevance (information retrieval) ,030212 general & internal medicine ,Cardiology and Cardiovascular Medicine ,business ,J wave ,Brugada syndrome - Abstract
This review includes main positions of the revision of diagnostic criteria of “J-wave syndromes in the J-Wave Syndromes Expert Consensus Conference Report: Emerging Concepts and Gaps in Knowledge” (2016). The article, systematized according to the sections of the above-mentioned document, outlines the questions of terminology, new criteria for diagnosis of the Brugada syndrome (BrS) and early repolarization syndrome (ERS). The section devoted to ERS on the issues of new terminology and standardization of measurements, is supplemented with material from the Consensus Paper - The Early Repolarization Pattern (2015). The article also presents the issues of differential diagnosis in BrS, presents modulating factors, defines acquired Brugada-pattern and Brugada phenocopies. The similarities and differences between BrS and ERS are presented in a comparative aspect.
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- 2018
6. [Recommendations of the Eurasian Arrhythmology Association (EURA) for the diagnosis and treatment of patients with arrhythmias and conduction disorders during the COVID-19 pandemic]
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A. A. Nechepurenko, Yu N Belenkov, E G Zhelyakov, Antonio Raviele, J. I. Karpenko, Luca Santini, V A Snezhitskiy, S. A. Abzaliyeva, S. A. Sayganov, Ardashev Av, D. A. Zateyshchikov, Aras Puodziukynas, S. A. Yuzvinkevitch, Riccardo Cappato, P. L. Shugaev, M. V. Yakovleva, and A. V. Konev
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medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Conduction disorders ,business.industry ,SARS-CoV-2 ,Pneumonia, Viral ,COVID-19 ,Arrhythmias, Cardiac ,Disease ,Cardiovascular surgeons ,Betacoronavirus ,Cardiac Conduction System Disease ,Heart Conduction System ,Epidemiology ,Pandemic ,Health care ,medicine ,Etiology ,Humans ,Cardiology and Cardiovascular Medicine ,Intensive care medicine ,business ,Coronavirus Infections ,Pandemics - Abstract
The beginning of 2020 was characterized by the development of a new coronavirus pandemic (COVID-19). Information about the epidemiology, etiology, pathogenesis, clinical and laboratory diagnostics, as well as prevention and therapy for this disease is constantly being expanded and reviewed. The COVID-19 pandemic creates the need for the emergence of new conditions of specialized care for patients with heart rhythm and conduction disorders [1]. These recommendations are intended for general practitioners, internists, cardiologists, electrophysiologists/arrhythmologists, cardiovascular surgeons, functional diagnostics doctors, anesthesiologists-resuscitators, laboratory diagnostics specialists, health care organizers in the system of organizations and healthcare institutions that provide specialized care to patients with heart rhythm and conduction disorders.
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- 2020
7. [Combined Approach for Management of the Chronic Heart Failure with Preserved Left Ventricular Ejection Fraction and Permanent Atrial Fibrillation: a Case Report]
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A. A. Kocharian, Ardashev Av, and E G Zhelyakov
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Male ,medicine.medical_specialty ,Combination therapy ,Amiodarone ,Ventricular Function, Left ,Muscle hypertrophy ,Internal medicine ,Atrial Fibrillation ,medicine ,Humans ,Sinus rhythm ,Aged ,Heart Failure ,Ejection fraction ,business.industry ,Sotalol ,Atrial fibrillation ,Stroke Volume ,medicine.disease ,Treatment Outcome ,Heart failure ,Cardiology ,Catheter Ablation ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Abstract
The article described a clinical case of a patient with chronic heart failure (CHF) with preserved ejection fraction (CHF-PEF) and permanent normosystolic atrial fibrillation (AF). A 73 year-old man (body mass index, 26.4 kg /m2) with permanent normosystolic AF (duration, 10 years) was hospitalized for augmenting of CHF symptoms. The patient had NYHA II-III functional class CHF and a history of long-standing arterial hypertension. The patient received chronic therapy according to the effective guidelines (angiotensin receptor blockers, diuretics, beta-blockers, and new oral anticoagulants). Transthoracic echocardiography showed a normal ejection fraction (EF) (57 %), a moderate enlargement of the left atrium (48 mm), and moderate left ventricular (LV) hypertrophy. Radiofrequency catheter ablation (RFCA) of left atrial AF was performed. For preparation to the RFCA, the patient was administered propanorm two weeks prior to the procedure. Following external electrical cardioversion (ECV) after RFCA, sinus rhythm did not recover. The patient was prescribed amiodarone, and repeat ECV was performed in a month, which resulted in successful recovery of sinus rhythm. However, due to an increase in serum thyrotropic hormone, amiodaron was replaced with the sotalol therapy (240 mg/day). This resulted in development of symptomatic sinus bradycardia and AF relapse at 3 days after ECV. A dual-chamber cardioverter defibrillator was implanted to the patient; in another three months, repeat AF RFCA was performed with successful recovery of sinus rhythm. During the cardioverter testing for one year, the patient had one more AF episode, which was stopped by external ECV. Also, a 6-hour AF episode occurred at three months after the repeat RFCA. Symptoms of CHF disappeared by the 12th month. The combination therapy administered to the patient with normosystolic permanent AF and preserved EF, which included a pathogenetic therapy for CHF, antiarrhythmic drugs, implantation of a dual-chamber ECV, two sessions of AF RFCA, and repeat external ECVs, provided considerable improvement of CHF symptoms and stable sinus rhythm during a one-year follow-up. The return to sinus rhythm after 10 years of permanent AF necessitated changing the arrhythmia diagnosis to long-standing, persistent AF.
- Published
- 2020
8. CURRENT APPROACHES FOR THE DIAGNOSIS,RISK STRATIFICATION AND INTERVENTIONAL TREATMENT OF PATIENTS WITH ACUTE CORONARY SYNDROMES WITHOUT ST-SEGMENT ELEVATION
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E G Chelombit'ko, N S Afonina, N I Negrun, O V Himii, Ardashev Av, A V Konev, and A V Staferov
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medicine.medical_specialty ,Acute coronary syndrome ,Myocardial revascularization ,Interventional treatment ,business.industry ,medicine.medical_treatment ,Percutaneous coronary intervention ,Individual risk ,medicine.disease ,Risk stratification ,medicine ,Treatment strategy ,ST segment ,Intensive care medicine ,business - Abstract
This article reviews current approaches to diagnosis and determination of the individual risk of patients with acute coronary syndrome without ST-segment elevation. Guidelines for determining the choice of treatment strategy and the time slots for its implementation are discussed. We describe the technical features of the implementation of interventional treatment in this group of patients; the choice of methods of myocardial revascularization is discussed.
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- 2015
9. SUDDEN CARDIAC DEATH AND WOLFF-PARKINSON-WHITE ELECTROCARDIOGRAPHIC PATTERN: A REVIEW
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S E Mamchur and Ardashev Av
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medicine.medical_specialty ,Radiofrequency catheter ablation ,business.industry ,Internal medicine ,medicine ,Cardiology ,In patient ,medicine.symptom ,business ,medicine.disease ,Asymptomatic ,Sudden cardiac death - Abstract
The causes of sudden cardiac death in patients with Wolff-Parkinson-White syndrome are considered; necessity of endocardial electrophysiological study and radiofrequency catheter ablation is discussed, including asymptomatic patients with accessory pathways.
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- 2014
10. THE MECHANISMS AND CAUSES OF SUDDEN CARDIAC DEATH.FACTORS AND RISK STRATIFICATION IN CLINICAL PRACTICE. DEFINITIONS AND TERMS
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G P Arutyunov, E G Zhelyakov, Ardashev Av, and Yu N. Belenkov
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congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,business.industry ,Disease ,medicine.disease ,Sudden cardiac death ,Clinical Practice ,Calculated data ,hemic and lymphatic diseases ,Heart failure ,Health care ,Risk stratification ,Medicine ,business ,Intensive care medicine ,Cardiovascular mortality - Abstract
Cardiovascular mortality in Russia is one of the highest in the world and is 1462 deaths per 100,000 per year. The main mechanisms dramatic outcomes of cardiovascular disease are death due to heart failure and sudden cardiac death (SCD). According to the calculated data 200,000-250,000 patients died suddenly in Russia per year.The problem of the SCD is one of the urgent problems of healthcare because prevalence of it is growing up and there is obvious possibility of effective preventive measures.In the present article presents definitions associated with SCD, mechanisms, primary and secondary risk factors for SCD.
- Published
- 2014
11. [Comparison Clinical Data and Results of Mathematical Modeling in Radiofrequency Ablation of Permanent Atrial Fibrillation: Cardioversion Might Be the Final Stage in the Combined Treatment]
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Fin'ko Va, Yu N Belenkov, E G Zhelyakov, I M Kalyuzhniy, Mazurov Me, and Ardashev Av
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medicine.medical_specialty ,business.industry ,Radiofrequency ablation ,medicine.medical_treatment ,Atrial fibrillation ,macromolecular substances ,Cardioversion ,medicine.disease ,law.invention ,Combined treatment ,law ,Internal medicine ,medicine ,Cardiology ,Stage (cooking) ,Cardiology and Cardiovascular Medicine ,business - Abstract
AIM to compare the theoretical possibility of permanent atrial fibrillation (AF) elimination (on the model of the 6-wave re-entry) result.
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- 2017
12. CHEYNE-STOKES RESPIRATION DURING SLEEP AS THE MASK OF EXACERBATION OF IHD. DIAGNOSIS AND TREATMENT BY ADAPTIVE SERVOVENTILATION
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A L Kalinkin, I M Shestopalova, Ardashev Av, Oleg Kuzovlev, and O N Bertova
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medicine.medical_specialty ,Central sleep apnea ,Exacerbation ,business.industry ,Adaptive servo ventilation ,medicine.disease ,Sleep in non-human animals ,Cheyne–Stokes respiration ,Internal medicine ,Respiration ,medicine ,Cardiology ,medicine.symptom ,business - Abstract
The case report of the patient with complaints of recurrent sudden breathlessness at night is presented. The approach of the diagnosis and therapy is introduced. The effectiveness of the treatment of CheyneStokes respiration by adaptive servoventilation has been shown.
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- 2014
13. Successful Restoration by Radiophrequency Ablation and Maintenance of Sinus Rhythm in a Patient With Longstanding Persistent (for 21 years) Atrial Fibrillation
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Dorofeeva Np, Kornienko Aa, Zheliakov Eg, Ovchinnikov Rs, Chudinov Gv, Rybachenko Ms, Konev Av, and Ardashev Av
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medicine.medical_specialty ,Radiofrequency ablation ,business.industry ,medicine.medical_treatment ,Treatment outcome ,Atrial fibrillation ,Catheter ablation ,macromolecular substances ,medicine.disease ,law.invention ,Surgery ,law ,Radiofrequency catheter ablation ,Internal medicine ,Persistent atrial fibrillation ,Heart rate ,medicine ,Cardiology ,Sinus rhythm ,Cardiology and Cardiovascular Medicine ,business - Abstract
Clinical observation of a patient with atrial fibrillation persisting throughout 21 years is presented with discussion of results of radiofrequency catheter ablation.
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- 2014
14. Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients With Atrial Fibrillation
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Daniel B. Mark, Evgeny Pokushalov, Gerhard Hindricks, Riccardo Cappato, Kristi H. Monahan, Greg C. Flaker, Georg Noelker, Alexander Romanov, Douglas L. Packer, Karl-Heinz Kuck, Jeanne E. Poole, James A. Reiffel, Kerry L. Lee, David J. Wilber, Richard A. Robb, Hussein R. Al-Khalidi, Amiran Revishvili, L. Brent Mitchell, Tristram D. Bahnson, Yves Rosenberg, Neal Jeffries, Peter A. Noseworthy, T. Jared Bunch, Ardashev Av, Jonathan P. Piccini, Peter R. Kowey, Gerald V. Naccarelli, D. Wyn Davies, and Adam P. Silverstein
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Hemorrhage ,Catheter ablation ,Kaplan-Meier Estimate ,01 natural sciences ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,Recurrence ,Risk Factors ,law ,Atrial Fibrillation ,medicine ,Clinical endpoint ,Humans ,Sinus rhythm ,Registries ,030212 general & internal medicine ,0101 mathematics ,Stroke ,Aged ,Intention-to-treat analysis ,business.industry ,010102 general mathematics ,Atrial fibrillation ,General Medicine ,Middle Aged ,Cardiac Ablation ,medicine.disease ,Heart Arrest ,Intention to Treat Analysis ,Surgery ,Hospitalization ,Catheter Ablation ,Female ,business ,Anti-Arrhythmia Agents - Abstract
Importance Catheter ablation is effective in restoring sinus rhythm in atrial fibrillation (AF), but its effects on long-term mortality and stroke risk are uncertain. Objective To determine whether catheter ablation is more effective than conventional medical therapy for improving outcomes in AF. Design, Setting, and Participants The Catheter Ablation vs Antiarrhythmic Drug Therapy for Atrial Fibrillation trial is an investigator-initiated, open-label, multicenter, randomized trial involving 126 centers in 10 countries. A total of 2204 symptomatic patients with AF aged 65 years and older or younger than 65 years with 1 or more risk factors for stroke were enrolled from November 2009 to April 2016, with follow-up through December 31, 2017. Interventions The catheter ablation group (n = 1108) underwent pulmonary vein isolation, with additional ablative procedures at the discretion of site investigators. The drug therapy group (n = 1096) received standard rhythm and/or rate control drugs guided by contemporaneous guidelines. Main Outcomes and Measures The primary end point was a composite of death, disabling stroke, serious bleeding, or cardiac arrest. Among 13 prespecified secondary end points, 3 are included in this report: all-cause mortality; total mortality or cardiovascular hospitalization; and AF recurrence. Results Of the 2204 patients randomized (median age, 68 years; 37.2% female; 42.9% had paroxysmal AF and 57.1% had persistent AF), 89.3% completed the trial. Of the patients assigned to catheter ablation, 1006 (90.8%) underwent the procedure. Of the patients assigned to drug therapy, 301 (27.5%) ultimately received catheter ablation. In the intention-to-treat analysis, over a median follow-up of 48.5 months, the primary end point occurred in 8.0% (n = 89) of patients in the ablation group vs 9.2% (n = 101) of patients in the drug therapy group (hazard ratio [HR], 0.86 [95% CI, 0.65-1.15];P = .30). Among the secondary end points, outcomes in the ablation group vs the drug therapy group, respectively, were 5.2% vs 6.1% for all-cause mortality (HR, 0.85 [95% CI, 0.60-1.21];P = .38), 51.7% vs 58.1% for death or cardiovascular hospitalization (HR, 0.83 [95% CI, 0.74-0.93];P = .001), and 49.9% vs 69.5% for AF recurrence (HR, 0.52 [95% CI, 0.45-0.60];P Conclusions and Relevance Among patients with AF, the strategy of catheter ablation, compared with medical therapy, did not significantly reduce the primary composite end point of death, disabling stroke, serious bleeding, or cardiac arrest. However, the estimated treatment effect of catheter ablation was affected by lower-than-expected event rates and treatment crossovers, which should be considered in interpreting the results of the trial. Trial Registration ClinicalTrials.gov Identifier:NCT00911508
- Published
- 2019
15. PERSISTANT LEFT SUPERIOR VENA CAVA IN A PATIENT WITH AN IMPLANTED DUAL CHAMBERPASING SYSTEM
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Ardashev Av, V N Lesniak, A A Kocharyan, and R S Ovchinnikov
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Dual Chamber Pacemaker ,medicine.medical_specialty ,business.industry ,cardiovascular system ,medicine ,cardiovascular diseases ,Radiology ,Persistent left superior vena cava ,Clinical case ,medicine.disease ,business ,Sick sinus syndrome ,Left superior vena cava - Abstract
We described a clinical case of a 65-years patient with sick sinus syndrome with persistant left superior vena cava, whom was implanted dual chamber pacemaker.
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- 2015
16. CLINICAL ASPECTS OF TREATMENT OF PATIENTS WITH LONG-PERSISTENT FORMOF ATRIAL FIBRILLATION AND DECOMPENSATED CHRONIC HEART FAILURE, USING A METHODOF RADIOFREQUENCY CATHETER ABLATION AND CARDIAC RESYNCHRONIZATION THERAPY
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Ardashev Av, A V Konev, A A Kocharyan, E G Zhelyakov, and R R Guseynova
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Cardiac resynchronization therapy ,Decompensated chronic heart failure ,Atrial fibrillation ,medicine.disease ,Combined treatment ,Radiofrequency catheter ablation ,Internal medicine ,Heart failure ,Persistent atrial fibrillation ,cardiovascular system ,medicine ,Cardiology ,cardiovascular diseases ,Clinical case ,business - Abstract
The article describes a clinical case of a 64-years patient with long-lasting persistent atrial fibrillation with the progressive course of chronic heart failure, which successfully treated with CRT setting and RFA of AFib. Dynamic observation of the patient during 12 months confirmed the success of combined treatment – absence of arrhythmia recurrences and decreasing of NYHA heart failure functional class.
- Published
- 2013
17. Subcutaneous chronic implantable defibrillation systems in humans
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Warren Smith, Stefan G. Spitzer, Ian Crozier, Gust H. Bardy, Margaret Hood, Andrew A. Grace, Lucas V.A. Boersma, Riccardo Cappato, Luc Jordaens, Pierpaolo Lupo, Ardashev Av, and Cardiology
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medicine.medical_specialty ,business.industry ,Defibrillation ,medicine.medical_treatment ,Perforation (oil well) ,Electric Countershock ,Equipment Design ,Implantable cardioverter-defibrillator ,medicine.disease ,Sudden death ,Defibrillators, Implantable ,Electrodes, Implanted ,Defibrillation threshold ,Electrocardiography ,Parasternal line ,Physiology (medical) ,Internal medicine ,Ventricular Fibrillation ,Ventricular fibrillation ,medicine ,Cardiology ,Humans ,Implant ,Cardiology and Cardiovascular Medicine ,business - Abstract
The recent introduction of subcutaneous implantable cardioverter defibrillator (S-ICD) has raised attention about the potential of this technology for clinical use in daily clinical practice. We review the methods and results of the four studies conducted in humans for approval of this innovative technology for daily practice. Two studies using a temporary S-ICD system (acute human studies) were conducted to search for an appropriate lead configuration and energy requirements. For this purpose, 4 S-ICD configurations were tested in 78 patients at the time of transvenous (TV)-ICD implantation. The optimal configuration was tested in 49 more patients to comparatively assess the subcutaneous defibrillation threshold (S-DFT) versus the standard TV-ICD. Long-term implants were evaluated in 55 patients using an implanted system (chronic human study). The acute humans studies led to an optimal S-ICD configuration comprising a parasternal electrode and left anterolateral thoracic pulse generator. Both configurations successfully terminated 98% of induced ventricular fibrillation (VF), but significantly higher energy levels were required with S-ICD than with TV-ICD systems (36.6 +/- 19.8 J vs. 11.1 +/- 8.5 J). In the chronic study, all 137 VF episodes induced at time of implant were detected with a 98% conversion rate. Two pocket infections and four lead revisions were required during 10 +/- 1 months of follow-up. During this period, survival was 98%, and 12 spontaneous ventricular tachyarrhythmias were detected and treated by the device. These data show that the S-ICD systems here consistently detected and converted VF induced at time of implant as well as sustained ventricular tachyarrhythmias occurring during follow-up (248).
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- 2012
18. P374Computer modelling of paroxysmal and persistent atrial fibrillation ablation approaches and their extrapolation to clinical results
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M. Mazurov, E G Zhelyakov, I. Kaluzhny, and Ardashev Av
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medicine.medical_specialty ,business.industry ,Physiology (medical) ,medicine.medical_treatment ,Internal medicine ,Persistent atrial fibrillation ,medicine ,Cardiology ,Extrapolation ,Cardiology and Cardiovascular Medicine ,Ablation ,business - Published
- 2017
19. RADIOFREQUENCY ABLATION WPW SYNDROME IN PATIENT WITH EBSTEIN'S ANOMALY
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Ardashev Av, A V Konev, E G Zhelyakov, and M S Rybachenko
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medicine.medical_specialty ,Radiofrequency ablation ,business.industry ,Surgical correction ,medicine.disease ,WPW SYNDROME ,law.invention ,law ,Ebstein's anomaly ,cardiovascular system ,medicine ,In patient ,Radiology ,Anomaly (physics) ,business - Abstract
The case history of 19-year old patient with Ebstein's anomaly and WPW syndrome, which was held surgical correction of cardiac arrhythmias by radiofrequency ablation is described. 3-year observation of patient confirmed the success of the operation – absence episodes of arrhythmia
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- 2010
20. An Entirely Subcutaneous Implantable Cardioverter-Defibrillator
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David Wright, Riccardo Cappato, Stefan G. Spitzer, Ian Crozier, Alexander H. Maass, Pascal F.H.M. van Dessel, Gust H. Bardy, Robert E. Park, Warren Smith, Ardashev Av, Andrew A. Grace, Isabelle C. Van Gelder, Derek T. Connelly, Francis Murgatroyd, Pierpaolo Lupo, Johannes Sperzel, Dominic A.M.J. Theuns, Lucas V.A. Boersma, A. Oduro, Joerg Neuzner, Craig S. Barr, Reinoud E. Knops, Luc Jordaens, Iain Melton, Margaret Hood, Simon P. Fynn, Arthur A.M. Wilde, ACS - Amsterdam Cardiovascular Sciences, Cardiology, CCA -Cancer Center Amsterdam, APH - Amsterdam Public Health, General Practice, Faculteit Medische Wetenschappen/UMCG, and Cardiovascular Centre (CVC)
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Adult ,Male ,medicine.medical_specialty ,Heart Diseases ,Defibrillation ,medicine.medical_treatment ,Pilot Projects ,CHILDREN ,THERAPY ,Sudden death ,PERMANENT PACEMAKER LEADS ,Electrocardiography ,Young Adult ,Internal medicine ,MANAGEMENT ,medicine ,Humans ,FAILURE ,Aged ,Aged, 80 and over ,COMPLICATIONS ,medicine.diagnostic_test ,business.industry ,SURGICAL REVISION ,Stroke Volume ,Equipment Design ,General Medicine ,Stroke volume ,Middle Aged ,Implantable cardioverter-defibrillator ,medicine.disease ,Defibrillators, Implantable ,Electrodes, Implanted ,Surgery ,CONGENITAL HEART-DISEASE ,Clinical trial ,Parasternal line ,Ventricular fibrillation ,Cardiology ,Female ,FOLLOW-UP ,business ,FIDELIS - Abstract
BACKGROUNDImplantable cardioverter-defibrillators (ICDs) prevent sudden death from cardiac causes in selected patients but require the use of transvenous lead systems. To eliminate the need for venous access, we designed and tested an entirely subcutaneous ICD system.METHODSFirst, we conducted two shortterm clinical trials to identify a suitable device configuration and assess energy requirements. We evaluated four subcutaneous ICD configurations in 78 patients who were candidates for ICD implantation and subsequently tested the best configuration in 49 additional patients to determine the subcutaneous defibrillation thresh old in comparison with that of the standard transvenous ICD. Then we evaluated the long-term use of subcutaneous ICDs in a pilot study, involving 6 patients, which was followed by a trial involving 55 patients.RESULTSThe best device configuration consisted of a parasternal electrode and a left lateral thoracic pulse generator. This configuration was as effective as a transvenous ICD for terminating induced ventricular fibrillation, albeit with a significantly higher mean (+/- SD) energy requirement (36.6 +/- 19.8 J vs. 11.1 +/- 8.5 J). Among patients who received a permanent subcutaneous ICD, ventricular fibrillation was successfully detected in 100% of 137 induced episodes. Induced ventricular fibrillation was converted twice in 58 of 59 patients (98%) with the delivery of 65-J shocks in two consecutive tests. Clinically significant adverse events included two pocket infections and four lead revisions. After a mean of 10 +/- 1 months, the device had successfully detected and treated all 12 episodes of spontaneous, sustained ventricular tachyarrhythmia.CONCLUSIONSIn small, nonrandomized studies, an entirely subcutaneous ICD consistently detected and converted ventricular fibrillation induced during electrophysiological testing. The device also successfully detected and treated all 12 episodes of spontaneous, sustained ventricular tachyarrhythmia. (ClinicalTrials.gov numbers, NCT00399217 and NCT00853645.)
- Published
- 2010
21. 1673Postablative perimitral atrial flutter. Extrapolation of arrhythmia simulation data to ablation clinical results
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E G Zhelyakov, Yu N. Belenkov, I. Kaluzhny, M. Mazurov, and Ardashev Av
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medicine.medical_specialty ,business.industry ,Physiology (medical) ,medicine.medical_treatment ,Internal medicine ,Cardiology ,Extrapolation ,Medicine ,Cardiology and Cardiovascular Medicine ,business ,Ablation ,medicine.disease ,Atrial flutter - Published
- 2017
22. P375Cardioversion might be the end-point for radiofrequency ablation of long-lasting persistent atrial fibrillation patients: from computer modelling to clinical results of ablation
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E G Zhelyakov, M. Mazurov, I. Kaluzhny, Yu N. Belenkov, and Ardashev Av
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Long lasting ,medicine.medical_specialty ,End point ,business.industry ,Radiofrequency ablation ,medicine.medical_treatment ,Ablation ,law.invention ,law ,Physiology (medical) ,Internal medicine ,Persistent atrial fibrillation ,medicine ,Cardiology ,Computer modelling ,Cardiology and Cardiovascular Medicine ,business - Published
- 2017
23. [Approximation of mathematical scanning simulation data and clinical results f radiofrequency ablation of perimitral atrial flutter. Condition of existence of perimitral atrial flutter]
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Ardashev Av, Mazurov Me, Fin'ko Va, Kaliuzhnyĭ Im, Zheliakov Eg, and Belenkov IuN
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Adult ,Male ,Reoperation ,medicine.medical_specialty ,Radiofrequency ablation ,medicine.medical_treatment ,Risk Assessment ,law.invention ,Pulmonary vein ,Postoperative Complications ,law ,Left atrial ,Heart Rate ,Internal medicine ,medicine ,Secondary Prevention ,Humans ,Aged ,Atrium (architecture) ,business.industry ,Middle Aged ,Models, Theoretical ,Ablation ,medicine.disease ,Myocardial Contraction ,Autowave ,Ostium ,Treatment Outcome ,Atrial Flutter ,cardiovascular system ,Cardiology ,Catheter Ablation ,Female ,Cardiology and Cardiovascular Medicine ,business ,Atrial flutter - Abstract
AIM 1) to create Perimitral Atrial Flutter (PMAFL) model and estimate theoretical probability of elimination of perimital reetntry using left atrial geometry two-dimensional mathematical modeling and ablative formatting; 2) to compare clinical results of PMAFL ablation by means of mitral vs inferioseptal isthmus ablation and mathematical modeling data. MATERIAL AND METHODS Clinical phase. Study was conducted on 24 pts (6 women, 57.1 ± 9.3 years) with PMAFL. Initially RF-lesions delivered in LA in the MI (endocardial approach to MI). Distal CS roof ablation (epicardial approach to MI) was a second step. As a third step linear RF-lessions of the inferioseptal isthmus (ISI)- from right pulmonary vein ostium to mitral annulus was performed (endocardial approach to ISI). As a fourth step RF-applications applied inside the proximal CS roof (epicardial approach to ISI). Mathematical phase. As the first step numeric reconstruction of the autowave process in excitable tissues of the left atrium was performed. Fitzhugh-Nagumo equation was used for simulation to enabled us to take into account the electrical inhomogeneity of the atria (pulmonary vein ostia). A special scanning method was used for calculating characteristics of autowave processes in a two-dimensional mathematical model of the atrium. As the second step simulation of linear ablation formatting which linked PV ostia and active medium boundaries (corresponding to mitral and inferioseptal isthmus ablation lines) was performed. RESULTS Clinical phase. Left MI endocardial RFA terminated PMAFL in 6 cases, increased CL without changes of atrial hierarchy activation in 2 cases, and transformed PMAFL to AFib in 2 cases. Distal CS ablation terminated PMAFL in 2 pts. Endocardial ISI ablation of associated with SR restoration in 2 cases and increasing of PMAFL CL in 5 cases. Proximal CS-roof ablation terminated PMAFL in 12 pts. Follow up was 26.7 ± 12.4 mos. Endocardial and epicardial MI approach terminated PMAFL in 8 pts (36%). RFA of endocardial 39nd epicardial aspects of the ISI restored SR in 12 pts (64%) (p< 0.05). MATHEMATICAL PHASE: There are three definite conditions of PMAFL existing: 1) Initial autowave spreading between superior PV and boundary of medium (corresponding to patent conduction between superior PV ostia and mitral annulus); 2) Non-active medium existing between four PV ostia (corresponding to PV isolation after index ablation); 3) Refractory characteristics of medium (corresponding to posterior wall of LA) and medium between PV ostia and boundaries (corresponding to isthmus zones) have to differ each other. The linear ablation patterns (from PV ostia to boundary of medium) suppress PAMFL in two-dimensional mathematical modeling of the left atrium. CONCLUSION There are definite conditions of PAMFL simulation by means autowave processing in a 2-D active medium using scanning algorithm. Those conditions may consistent with certain EP characteristics of LA after index ablation clinical results of PAMFL ablation.
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- 2014
24. AF Ablation I
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E G Zhelyakov, Jianqiang Hu, S. Noor Asyikin, Xiang Mei, Wenliang Lu, Lianjun Gao, Zhaohui Qiu, M.S. Rybatchenko, Kailei Shi, Prasant Mohanty, Andrea Natale, Yanzong Yang, Dejun You, Jiaoyou Zhang, G. S. Tay, Rong Bai, O. Razali, Michela Casella, De-ning Liao, Ardashev Av, H. Azlan, Xiaowen Xu, Luigi Di Biase, Xue Zhao, Dong Chang, A. Zunida, A. V. Konev, Claudio Tondo, Sanghamitra Mohanty, Li Dai, Sakis Themistoclakis, Shulong Zhang, Yu N. Belenkov, K. Surinder, Claude S. Elayi, and Xingui Guo
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Pathology ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Catheter ablation ,Atrial fibrillation ,Cardioversion ,medicine.disease ,Ablation ,Pulmonary vein ,Surgery ,medicine.anatomical_structure ,Physiology (medical) ,Internal medicine ,Cardiology ,Medicine ,Sinus rhythm ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Atrial tachycardia ,Interatrial septum - Abstract
Target of ablation of peri-mitral flutter: mitral valve isthmus or triggers? {#article-title-2} Introduction Patients with previous ablation for atrial fibrillation (AF) may experience the recurrence of peri-mitral flutter (PMFL). These arrhythmias are usually triggered from sources that may also induce atrial fibrillation. We sought to determine whether ablation of triggers or completing mitral valve isthmus (MVI) block prevents more arrhythmia recurrences. Methods A total of 65 patients with recurrent PMFL after initial ablation of long-standing persistent AF were included in the study. Thirty-two were randomized to MVI ablation only (Group 1) and 33 were randomized to cardioversion and repeat pulmonary vein (PV) isolation plus ablation of others non-PV triggers (Group 2). Results MVI bidirectional block was achieved in all but one patient from Group 1. In Group 2, reconnection of 17 PVs was detected in 14 patients (42%, 1.21 veins per patient). With isoproterenol challenge, 44 non-PV trigger sites were identified in 28 patients (85%, 1.57 sites per patient). With a follow-up of 18 months, 27 patients (84%) from Group 1 had recurrent atrial arrhythmias and 15 remained on AAD, while 28 patients from Group 2 (85%, P < 0.0001 vs. Group 1) were free of arrhythmia off AAD. Cox regression model revealed that the ablation strategy used in Group 2 was associated with a significant lower risk of recurrence of atrial tachyarrhythmia (hazard ratio = 0.10, 95% CI = 0.04–0.28, P < 0.001). The Kaplan–Meier curves demonstrated significant better arrhythmia-free survival in Group 2 compared with Group 1 (log rank P < 0.0001). Conclusions In patients presenting with PMFL after ablation for long-standing persistent AF, MVI block had limited impact on arrhythmia recurrence. On the other hand, elimination of all PV and non-PV triggers achieved higher freedom from atrial arrhythmias at follow-up. # Comparison of sensitivity of transthoracic, transoesophageal, and intracardiac echocardiography for guiding transeptal puncture {#article-title-3} Objective Compare the sensitivity of transthoracic (TTE), transoesophageal (TEE), and intracardiac (ICE) echocardiography for guiding interatrial septum (IAS) puncture. Methods The study consisted of 208 patients (48 females, mean age 56.4 ± 11.3 years) who underwent RFA of LA because of atrial fibrillation. Transeptal puncture was performed after IAS visualization using TTE in 32 (15.4%), TEE in 26 (12.5%), ICE in 150 (72.1%) patients. Adequate contact of transeptal needle with IAS was defined as a tension of septum using echocardiographic techniques. Verification of tenting and following transeptal puncture with LA catheterization was defined as a true positive result. Lack of visualization of tenting with successful transeptal puncture under fluoroscopy was defined as a false-negative result. Results Clear visualization of the IAS using TTE technique was demonstrated in 2 (6%) cases, and the sensitivity amounted for 6.7%. Obvious verification of IAS by TEE was revealed in 20 (77%) patients, and sensitivity of this technique was 86.9%. ICE control of septum puncture was performed in 127 patients. ICE allowed visualizing septum and tenting in 125 patients and the tension of septum was unable to be determined in two cases despite of the efforts of specialists. ICE sensitivity for IAS verification was 98.4%. Conclusion ICE is the most sensitive ultrasound technique for verification of optimal location of the transeptal needle in the region of IAS comparing with TTE and TEE. # Pulmonary antrum radial-linear ablation: a new therapy for atrial fibrillation {#article-title-4} The abnormality of substrates in pulmonary vein antrum (PVA) plays a critical role in maintaining atrial fibrillation (AF). PVA radial-linear ablation (PVARA) was performed for an organized modification of substrates in paroxysmal AF. This study consisted of two phases: preclinical phase using 22 canine models with acutely induced AF, and clinical phase in patients with paroxysmal AF ( n = 15) in paired control with PV isolation. Radial-linear lesions were created from PV orifice to left atrium-PV junction in both dogs and patients. Successful creation of chronic radial-linear lesions was confirmed pathologically in dogs. The AF inducibility and duration decreased by 89 and 90%, respectively, after ablation in dogs. All the patients showed inducible AF prior to the procedure. No AF was inducible immediately after PVARA in 14 patients. The procedural time was significantly shorter in patients with PVARA than PV isolation. Within 1 week after ablation, there were six patients with early recurrent AF and seven with atrial tachycardia (AT) in PVARA group, and three patients with AF and six with AT in control. During follow-up of 6–12 months, 11 patients were free of AF and AT with four patients taking propafenone or amiodarone in the PVARA group, and nine patients free of AF and AT with seven patients taking propafenone or amiodarone in control. No complication related to the ablation developed in the two groups. This pilot study demonstrated that PVARA was a simple and safe strategy for paroxysmal AF ablation, and might provide a better long-term outcome than PV isolation. # Pulmonary vein isolation with a multi-electrode ablation catheter using duly-cycled bipolar and unipolar radiofrequency energy {#article-title-5} Background Traditional catheter ablation of atrial fibrillation (AF) requires long procedure times and high level of operator skill. A multielectrode catheter (PVAC, ablation frontier) combining circular mapping and duly-cycled bipolar and unipolar radiofrequency energy delivery has been developed to map and isolate the pulmonary veins. Aim The aim of this study to evaluate the efficacy of PVAC for pulmonary vein isolation in paroxysmal AF ablation. Methods Fifty consecutive patients with paroxysmal AF who had failed at least one anti-arrhythmic drug and eligible for catheter ablation were included in the study. All four pulmonary veins were isolated and confirmed the absence of pulmonary vein potentials with PVAC. At six months, 48 h Holter monitoring was performed to determine freedom of AF. Results All patients had structurally normal hearts with a mean duration of AF of 4.28 + 4.39 years. The mean procedure time was 109.74 + 28.35 min. Mean fluoroscopy time was 36.52 + 12.29 min. Mean number of RF applications were 27.79 + 13.80 min. The mean follow-up duration was 9.39 + 4.90 months. After AF ablation with PVAC, 36 patients completed 6-month follow-up and 25 patients (69.4%) were in sinus rhythm without drugs. No procedure-related complication was observed. Conclusions Pulmonary vein isolation using the PVAC has a success rate of ∼70% with the first ablation. # Autonomic mechanism for complex fractionated atrial electrograms: evidence by pathology {#article-title-6} Background The mechanism(s) underlying complex fractionated atrial electrograms (CFAEs) has not been well elucidated. The present study addressed to observe the histological characteristics at the area with CFAEs in canine atria to investigate the mechanism of CFAEs. Methods Ten adult mongrel dogs were involved in the present study. AF was induced through rapid atrial pacing with vagosympathetic nerve stimulation. CFAEs was recorded by Lasso catheter. Irrigated ablation was performed at sites with CFAEs. After finishing procedures above, all dogs were sacrificed and the whole hearts were taken out and fixed in 4¢Hformalin for more than 48 hours for histological examination. The specimens were divided into CFAEs group and non-CFAEs group. Serial sections were taken and stained with hematoxylin and eosin(HE) and general neural marker protein gene product 9.50(PGP9.50), respectively. Compare the characteristics of myocardial and autonomic nerve distribution between the CFAEs and non-CFAEs groups. Results Sections stained by HE: The myocardium in non-CFAEs group was well-arranged, usually in parallel with little interstitial and epicardial adipose tissue. However, the myocardium in CFAEs group distributed in disorganization with more interstitial tissue and epicardial adipose tissue. Nerve fibers and ganglionated plexi (autonomic nerves) in CFAEs group were more abundant than non-CFAEs group (7±5.4 vs. 1.9±2.7; P
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- 2011
25. P1-65
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Ardashev Av, Warren Smith, Margaret Hood, Andrew A. Grace, Riccardo Cappato, and Gust H. Bardy
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medicine.medical_specialty ,business.industry ,Physiology (medical) ,Internal medicine ,Icd lead ,Cardiology ,Medicine ,Implantable defibrillator ,Cardiology and Cardiovascular Medicine ,business - Published
- 2006
26. P-304 Could nonlinear dynamic methods predict natural time course of paroxysmal atrial fibrillation?
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V.I. Steklov, Klimov Vp, Ardashev Av, P.A. Novoselskiy, O.I. Kucherik, and N.V. Kornejev
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Nonlinear system ,medicine.medical_specialty ,Paroxysmal atrial fibrillation ,business.industry ,Physiology (medical) ,Internal medicine ,Time course ,Cardiology ,medicine ,Cardiology and Cardiovascular Medicine ,business - Published
- 2003
27. An entirely subcutaneous implantable cardioverter-defibrillator.
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Bardy GH, Smith WM, Hood MA, Crozier IG, Melton IC, Jordaens L, Theuns D, Park RE, Wright DJ, Connelly DT, Fynn SP, Murgatroyd FD, Sperzel J, Neuzner J, Spitzer SG, Ardashev AV, Oduro A, Boersma L, Maass AH, and Van Gelder IC
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- 2010
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28. [Clinical case of the cardiovascular system involvement in a patient with Charcot-Marie-Tooth disease].
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Sokolov DV, Zhelyakov EG, Koval'chuk VV, Kondratova NV, Snezhitskij VA, Kalatsei LV, Belenkov YN, and Ardashev AV
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- Humans, Sick Sinus Syndrome, Cardiovascular System, Charcot-Marie-Tooth Disease complications, Charcot-Marie-Tooth Disease diagnosis, Charcot-Marie-Tooth Disease therapy
- Abstract
Hereditary motor and sensory type 1A neuropathy (known as Charcot-Marie-Tooth disease) is a disease of peripheral nerves characterized by symptoms of progressive polyneuropathy with preferential damage of distal extremity muscles. Damage to the cardiovascular system is extremely rare and heterogenous in this pathology. This disease is not included in the list of indications for interventional antiarrhythmic aid. We could not find in available literature a clinical description of the development of sinus node dysfunction associated with this pathology. The present clinical report presents a case of detection and successful treatment of a damage to the cardiovascular system that manifested itself as sinus node dysfunction/sick sinus syndrome in the tachy-brady variant. A combination treatment approach using radiofrequency catheter ablation, implantation of a permanent pacemaker, and antiarrhythmic therapy associated with drug and non-drug treatment of motor sensory neuropathy resulted in recovery and long-term maintenance of sinus rhythm as well as in beneficial changes in the patient's neurological status.
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- 2022
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29. [Use of Statins, Anticoagulants, Antiaggregants and Antiarrhythmic Drugs in Patients With COVID-19. The Agreed Experts' Position of Russian Society of Cardiology, Eurasian Association of Therapists, National Society on Atherothrombosis, Societies of Experts in Urgent Cardiology, Eurasian Arrhythmology Association].
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Shlyakhto YV, Arutyunov GP, Belenkov YN, Tarlovskaya EI, Konradi AO, Panchenko EP, Yavelov IS, Tereshchenko SN, Ardashev AV, Arutyunov AG, Grigorieva NY, Dzhunusbekova GA, Drapkina OM, Koziolova NA, Komarov AL, Kropacheva ES, Malchikova SV, Mitkovskaya NP, Orlova YA, Petrova MM, Rebrov AP, Sisakian H, Skibitsky VV, Sugraliyev AB, Fomin IV, Chesnikova AI, Shaposhnik II, Zhelyakov EG, Kanorskii SG, Kolotsey LV, and Snezhitskiy VA
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- Anti-Arrhythmia Agents therapeutic use, Betacoronavirus, COVID-19, Humans, Russia, SARS-CoV-2, Societies, Medical, COVID-19 Drug Treatment, Anticoagulants therapeutic use, Cardiology, Coronavirus Infections drug therapy, Coronavirus Infections epidemiology, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Pandemics, Pneumonia, Viral drug therapy, Pneumonia, Viral epidemiology
- Abstract
This article discusses relevant aspects in the treatment of patients with COVID-19. Up-to-date information about principles for administration of statins, antithrombotics, and antiarrhythmics is presented. The authors addressed in detail specific features of reversing heart rhythm disorders in patients with coronavirus infection and the interaction of antiarrhythmic and antiviral drugs. Recommendations are provided for outpatient and inpatient antithrombotic therapy for patients with COVID-19. Issues of antithrombotic and antiviral drug interaction are discussed.
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- 2020
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30. [Recommendations of the Eurasian Arrhythmology Association (EURA) for the diagnosis and treatment of patients with arrhythmias and conduction disorders during the COVID-19 pandemic].
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Belenkov YN, Snezhitskiy VA, Ardashev AV, Abzaliyeva SA, Cappato R, Karpenko JI, Konev AV, Nechepurenko AA, Raviele A, Puodziukynas A, Sayganov SA, Santini L, Shugaev PL, Yakovleva MV, Zateyshchikov DA, Yuzvinkevitch SA, and Zhelyakov EG
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- Betacoronavirus, COVID-19, Heart Conduction System physiopathology, Humans, Pandemics, SARS-CoV-2, Arrhythmias, Cardiac diagnosis, Arrhythmias, Cardiac therapy, Cardiac Conduction System Disease diagnosis, Cardiac Conduction System Disease therapy, Coronavirus Infections epidemiology, Pneumonia, Viral epidemiology
- Abstract
The beginning of 2020 was characterized by the development of a new coronavirus pandemic (COVID-19). Information about the epidemiology, etiology, pathogenesis, clinical and laboratory diagnostics, as well as prevention and therapy for this disease is constantly being expanded and reviewed. The COVID-19 pandemic creates the need for the emergence of new conditions of specialized care for patients with heart rhythm and conduction disorders [1]. These recommendations are intended for general practitioners, internists, cardiologists, electrophysiologists/arrhythmologists, cardiovascular surgeons, functional diagnostics doctors, anesthesiologists-resuscitators, laboratory diagnostics specialists, health care organizers in the system of organizations and healthcare institutions that provide specialized care to patients with heart rhythm and conduction disorders.
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- 2020
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31. [Combined Approach for Management of the Chronic Heart Failure with Preserved Left Ventricular Ejection Fraction and Permanent Atrial Fibrillation: a Case Report].
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Ardashev AV, Zhelyakov EG, and Kocharian AA
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- Aged, Humans, Male, Stroke Volume, Treatment Outcome, Ventricular Function, Left, Atrial Fibrillation, Catheter Ablation, Heart Failure
- Abstract
The article described a clinical case of a patient with chronic heart failure (CHF) with preserved ejection fraction (CHF-PEF) and permanent normosystolic atrial fibrillation (AF). A 73 year-old man (body mass index, 26.4 kg /m2) with permanent normosystolic AF (duration, 10 years) was hospitalized for augmenting of CHF symptoms. The patient had NYHA II-III functional class CHF and a history of long-standing arterial hypertension. The patient received chronic therapy according to the effective guidelines (angiotensin receptor blockers, diuretics, beta-blockers, and new oral anticoagulants). Transthoracic echocardiography showed a normal ejection fraction (EF) (57 %), a moderate enlargement of the left atrium (48 mm), and moderate left ventricular (LV) hypertrophy. Radiofrequency catheter ablation (RFCA) of left atrial AF was performed. For preparation to the RFCA, the patient was administered propanorm two weeks prior to the procedure. Following external electrical cardioversion (ECV) after RFCA, sinus rhythm did not recover. The patient was prescribed amiodarone, and repeat ECV was performed in a month, which resulted in successful recovery of sinus rhythm. However, due to an increase in serum thyrotropic hormone, amiodaron was replaced with the sotalol therapy (240 mg/day). This resulted in development of symptomatic sinus bradycardia and AF relapse at 3 days after ECV. A dual-chamber cardioverter defibrillator was implanted to the patient; in another three months, repeat AF RFCA was performed with successful recovery of sinus rhythm. During the cardioverter testing for one year, the patient had one more AF episode, which was stopped by external ECV. Also, a 6-hour AF episode occurred at three months after the repeat RFCA. Symptoms of CHF disappeared by the 12th month. The combination therapy administered to the patient with normosystolic permanent AF and preserved EF, which included a pathogenetic therapy for CHF, antiarrhythmic drugs, implantation of a dual-chamber ECV, two sessions of AF RFCA, and repeat external ECVs, provided considerable improvement of CHF symptoms and stable sinus rhythm during a one-year follow-up. The return to sinus rhythm after 10 years of permanent AF necessitated changing the arrhythmia diagnosis to long-standing, persistent AF.
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- 2020
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32. [The First in Russia Experience of Successful Implementation of Constant Neurostimulation of the Spinal Cord in the Complex Treatment of a Patient with Permanent Form of Atrial Fibrillation Combined with Spinal Stenosis].
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Yakovlev AE, Yakovleva MV, Chaykovskaya MK, and Ardashev AV
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- Humans, Russia, Spinal Cord, Atrial Fibrillation, Spinal Stenosis
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This article describes for the first time in the domestic literature a clinical case of the therapeutic effect of neuromodulation on the permanent form of atrial fibrillation and chronic heart failure in an elderly patient with spinal stenosis which led to the development of pain syndrome and movement disorders. For the treatment of neurological pathology, at the beginning epidural administration of drugs was applied, followed by spinal cord stimulation trial and implantation of permanent neurostimulator. At each stage of treatment conducted by a functional neurosurgeon the patient had a spontaneous restoration of sinus rhythm, and during continuous neurostimulation a stable retention of sinus rhythm and regression of heart failure symptoms have been observed throughout a long observation period. The article also presents the data of a few experimental and clinical studies on the use of neuromodulation in cardiology, describes the method of implantation of spinal electrodes and analyzes possible mechanisms of modulation of the autonomic innervation of the heart, implemented by spinal cord stimulation.
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- 2019
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33. Update of the Diagnostic Criteria of J-Wave Syndrome: New Concepts and Their Relevance to Cardiology Practice (According to Materials of J-Wave Syndromes Expert Consensus Conference Report: Emerging Concepts and Gaps in Knowledge (2016).
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Belenkov YN, Snezhitskiy VA, Gizatulina TP, Shpak NV, Kuznetsov VA, Martyanova LU, and Ardashev AV
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- Arrhythmias, Cardiac, Consensus, Diagnosis, Differential, Humans, Brugada Syndrome, Electrocardiography
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This review includes main positions of the revision of diagnostic criteria of "J-wave syndromes in the J-Wave Syndromes Expert Consensus Conference Report: Emerging Concepts and Gaps in Knowledge" (2016). The article, systematized according to the sections of the above-mentioned document, outlines the questions of terminology, new criteria for diagnosis of the Brugada syndrome (BrS) and early repolarization syndrome (ERS). The section devoted to ERS on the issues of new terminology and standardization of measurements, is supplemented with material from the Consensus Paper - The Early Repolarization Pattern (2015). The article also presents the issues of differential diagnosis in BrS, presents modulating factors, defines acquired Brugada-pattern and Brugada phenocopies. The similarities and differences between BrS and ERS are presented in a comparative aspect.
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- 2018
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34. [Clinical Aspects of Interventional Treatment of a Patient With Atrial Fibrillation Combined With Resistant Arterial Hypertension by the Method of Radiofrequency Ablation in Renal Arteries and Left Atrium].
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Ardashev AV, Zhelyakov EG, Zotova IV, Konev AV, Khimiy OV, Staferov AV, Knigin AV, Kolesnikov VN, Maskova NA, Baykulova MK, and Belenkov YN
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- Heart Atria, Humans, Radiofrequency Ablation, Renal Artery, Treatment Outcome, Atrial Fibrillation, Catheter Ablation, Hypertension
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- 2017
35. Isolation and complete genome sequencing of rabies virus strain isolated from a brown bear (Ursus arctos) that attacked a human in Primorsky krai (November, 2014).
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Shchelkanov MY, Deviatkin AA, Ananiev VY, Frolov EV, Dombrovskaya IE, Dedkov VG, Ardashev AV, Kolomeets SA, Korotkova IP, Lyubchenko EN, Bandeev VV, Prosyannikova MN, Galkina IV, Ivanushko ES, Emelyanova NP, Baranov NI, Ulyanova SA, Aramilev SV, Fomenko PV, Surovy AL, Poroshin NA, Sokol NN, Maslov DV, Makhinya EE, and Shipulin GA
- Abstract
An attack of a brown bear (Ursus arctos) on human was detected in November, 2014 in the Barabash village (Khasan region of the Primorski krai) located in close proximity to the national park Land of the Leopard. The bear was shot. The deviant behavior of the bear indicated the possibility of rabies. The diagnosis was confirmed by means of laboratory methods. The strain RABV/Ursus arctos/Russia/Primorye/PO 01/2014 (further PO 01) was isolated from the brain of the bear. PO 01 is the first completely sequenced Far Eastern strain of RABV. It can be considered as topotypic. PO 01 considerably differs from the vaccine strain RV 97 (GenBank EF542830) that is the basis of attenuated vaccine applied in the Land of the Leopard. At the same time, the immunodominant sites in PO 01 and RV 97 proteins differ slightly. It can be recommended to continue application of the vaccine. The analysis of the PO 01 genome (GenBank KP997032) revealed its belonging to the Eurasian genetic subgroup of the genotype 1 (street rage). Thus, this genetic subgroup stretches to the East. Expansion of the cross-border protected territories of Russia and China in the Far East demands the correct statistics of circulation of the lyssaviruses to be kept.
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- 2016
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36. [Clinical Case of Severe Heart Failure Treatment, Produced due to the Development of Arrhythmogenic Cardiomyopathy in a Patient With Permanent Junctional Reciprocating Tachycardia (Coumels Tachycardia) With Additional Left Lateral Accessory Pathway].
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Ardashev AV, Ovchinnikov RS, Zhelyakov EG, Ivanova AV, and Fomin YY
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- Accessory Atrioventricular Bundle, Child, Preschool, Humans, Male, Ventricular Remodeling, Cardiomyopathies complications, Catheter Ablation, Electrocardiography, Heart Failure etiology, Heart Failure therapy, Tachycardia, Supraventricular complications
- Abstract
Thirty two years old man had history of atrioventricular re-entry tachycardia (AVRT) with concealed left-lateral accessory pathway (AP), 3-5episodes per year, 30-40 minutes duration without hemodynamic compromise. Two years ago patient underwent ablation of concealed left lateral AP. After that tachycardia became malignant (high-frequent 150 beats-min, incessant (lasting up to 18 h/day), resistant to AAD, and led to development of tachycardia-induced cardiomyopathy (EF was 16%, and 2 episodes of pulmonary oedema). During redo EPS we verified AVRT with conduction via decremental retrograde left lateral AP which corresponded to the criteria of permanent junctional reciprocating tachycardia (PJRT). Ablation effectively ceased the arrhythmia. After 18 months of follow up there are no symptoms of heart failure and recurrence of arrhythmia., Conclusions: We present a case of effective treatment of severe heart failure in a patient with arhythtmogenic cardiomyopathy due to malignant course of incessant tachycardia AVRT with retrograde decremental conduction via left lateral AP. Ablation of AP eliminated of arrhythmia. After 18 months of follow up patient had signs of left ventricle reverse remodeling and had not heart failure symptoms.
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- 2016
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37. [Comparison Clinical Data and Results of Mathematical Modeling in Radiofrequency Ablation of Permanent Atrial Fibrillation: Cardioversion Might Be the Final Stage in the Combined Treatment].
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Ardashev AV, Mazurov ME, Zhelyakov EG, Kalyuzhniy IM, Finko VA, and Belenkov YN
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Aim: to compare the theoretical possibility of permanent atrial fibrillation (AF) elimination (on the model of the 6-wave re-entry) result.
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- 2015
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38. [Endocardial Electrophysiological Study in an Asymptomatic Competitive Athlete With Ventricular Preexitation due to Conduction via Fasciculoventricular Accessory Pathway].
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Guseynova RR, Zhelyakov EG, Ardashev AV, and Belenkov YN
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- Accessory Atrioventricular Bundle diagnosis, Humans, Accessory Atrioventricular Bundle physiopathology, Athletes, Electrocardiography methods, Heart Rate physiology, Heart Ventricles physiopathology
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We present a clinical case of a rare form of the WPW phenomenon due to anterograde conduction over fasciculoventricular accessory pathway in 20-year-old competitive athlete. The patient had no history of palpitations or syncope. ECG revealed shortening of PQ interval (112 ms) and wide QRS complex due to conduction via accessory pathway. To address the question of participation in competitive activity and the need for ablation the patient underwent endocardial electrophysiological study in the course of which we verified conduction via fasciculoventricular accessory pathway. The result of the study was used in determination of strategy of further management.
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- 2015
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39. [Successful restoration by radiofrequency ablation and maintenance of sinus rhythm in a patient with longstanding (for 21 years) persistent atrial fibrillation].
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Dorofeeva NP, Ovchinnikov RS, Konev AV, Zheliakov EG, Rybachenko MS, Chudinov GV, Kornienko AA, and Ardashev AV
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- Adult, Atrial Fibrillation physiopathology, Heart Rate, Humans, Male, Treatment Outcome, Atrial Fibrillation therapy, Catheter Ablation
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Clinical observation of a patient with atrial fibrillation persisting throughout 21 years is presented with discussion of results of radiofrequency catheter ablation.
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- 2014
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40. [Approximation of mathematical scanning simulation data and clinical results f radiofrequency ablation of perimitral atrial flutter. Condition of existence of perimitral atrial flutter].
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Mazurov ME, Ardashev AV, Zheliakov EG, Kaliuzhnyĭ I, Fin'ko VA, and Belenkov IuN
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- Adult, Aged, Female, Heart Rate, Humans, Male, Middle Aged, Models, Theoretical, Myocardial Contraction, Reoperation methods, Risk Assessment, Secondary Prevention, Treatment Outcome, Atrial Flutter etiology, Atrial Flutter physiopathology, Atrial Flutter surgery, Catheter Ablation adverse effects, Catheter Ablation methods, Postoperative Complications physiopathology, Postoperative Complications surgery
- Abstract
Aim: 1) to create Perimitral Atrial Flutter (PMAFL) model and estimate theoretical probability of elimination of perimital reetntry using left atrial geometry two-dimensional mathematical modeling and ablative formatting; 2) to compare clinical results of PMAFL ablation by means of mitral vs inferioseptal isthmus ablation and mathematical modeling data., Material and Methods: Clinical phase. Study was conducted on 24 pts (6 women, 57.1 ± 9.3 years) with PMAFL. Initially RF-lesions delivered in LA in the MI (endocardial approach to MI). Distal CS roof ablation (epicardial approach to MI) was a second step. As a third step linear RF-lessions of the inferioseptal isthmus (ISI)- from right pulmonary vein ostium to mitral annulus was performed (endocardial approach to ISI). As a fourth step RF-applications applied inside the proximal CS roof (epicardial approach to ISI). Mathematical phase. As the first step numeric reconstruction of the autowave process in excitable tissues of the left atrium was performed. Fitzhugh-Nagumo equation was used for simulation to enabled us to take into account the electrical inhomogeneity of the atria (pulmonary vein ostia). A special scanning method was used for calculating characteristics of autowave processes in a two-dimensional mathematical model of the atrium. As the second step simulation of linear ablation formatting which linked PV ostia and active medium boundaries (corresponding to mitral and inferioseptal isthmus ablation lines) was performed., Results: Clinical phase. Left MI endocardial RFA terminated PMAFL in 6 cases, increased CL without changes of atrial hierarchy activation in 2 cases, and transformed PMAFL to AFib in 2 cases. Distal CS ablation terminated PMAFL in 2 pts. Endocardial ISI ablation of associated with SR restoration in 2 cases and increasing of PMAFL CL in 5 cases. Proximal CS-roof ablation terminated PMAFL in 12 pts. Follow up was 26.7 ± 12.4 mos. Endocardial and epicardial MI approach terminated PMAFL in 8 pts (36%). RFA of endocardial 39nd epicardial aspects of the ISI restored SR in 12 pts (64%) (p< 0.05). MATHEMATICAL PHASE: There are three definite conditions of PMAFL existing: 1) Initial autowave spreading between superior PV and boundary of medium (corresponding to patent conduction between superior PV ostia and mitral annulus); 2) Non-active medium existing between four PV ostia (corresponding to PV isolation after index ablation); 3) Refractory characteristics of medium (corresponding to posterior wall of LA) and medium between PV ostia and boundaries (corresponding to isthmus zones) have to differ each other. The linear ablation patterns (from PV ostia to boundary of medium) suppress PAMFL in two-dimensional mathematical modeling of the left atrium., Conclusion: There are definite conditions of PAMFL simulation by means autowave processing in a 2-D active medium using scanning algorithm. Those conditions may consistent with certain EP characteristics of LA after index ablation clinical results of PAMFL ablation.
- Published
- 2014
- Full Text
- View/download PDF
41. [Methods of verification of bidirectional conduction block in cavotricuspid isthmus during treatment of typical atrial flutter].
- Author
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Ardashev AV, Konev AV, Zheliakov EG, Rybachenko MS, and Belenkov IuN
- Subjects
- Coronary Sinus pathology, Equipment Design, Humans, Outcome Assessment, Health Care, Retreatment statistics & numerical data, Secondary Prevention, Atrial Flutter diagnosis, Atrial Flutter physiopathology, Atrial Flutter therapy, Cardiac Catheters, Catheter Ablation instrumentation, Catheter Ablation methods, Heart Conduction System physiopathology
- Published
- 2013
42. [Long-term results of radiofrequency catheter ablation of long-lasting persistent atrial fibrillation: five years of follow-up].
- Author
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Ardashev AV, Zheliakov EG, Dupliakov DV, Konev AV, Rybachenko MS, Glukhova VL, Golovina GA, Skuratova MA, Fin'ko VA, and Belenkov IuN
- Subjects
- Adult, Aged, Atrial Fibrillation diagnosis, Atrial Fibrillation physiopathology, Comparative Effectiveness Research, Female, Follow-Up Studies, Heart Rate drug effects, Humans, Incidence, Male, Middle Aged, Outcome Assessment, Health Care, Postoperative Complications classification, Postoperative Complications diagnosis, Postoperative Complications physiopathology, Russia, Time, Treatment Outcome, Anti-Arrhythmia Agents therapeutic use, Atrial Fibrillation therapy, Catheter Ablation adverse effects, Catheter Ablation methods
- Abstract
Aim: To evaluate long-term results of radiofrequency catheter ablation (RFA) vs. rate-control strategy in patients with long-lasting persistent atrial fibrillation (AF) METHODS: We assessed 5-years results in 66 patients (53.3+/-12.3 years old, 8 women) with long-lasting persistent AF who underwent RFA (ablation group), as well as in age-gender-AF duration-matched patients who were treated with rate-control strategy (rate-control group).The ablation strategy consisted of wide-area circumferential lines around pulmonary veins, roof lines and extensive RFA of the left atrial substrate modification using a three-dimensional mapping system. Incidence of sinus rhythm (SR) maintenance, death, stroke, myocardial infarction (MI), worsening of heart failure (NYHA) were evaluated after 5 years of follow-up., Results: After 5 years of follow up SR was present in 38 (56%) of 42 who were under follow up patients of ablation group and all patients had AF in rate-control group (95% CI 0.02247-0.3598; p=0.0001). Seventeen (27%) patients of ablation group continued to take atniarrhythmic drugs. 29 (44%) patients of ablation group vs. 48 (73%) patients of rate-control group received warfarin (95% CI 0.442-1.1; p=0.046) at five years of follow up. After five years of follow up the incidence of MI, stroke, worsening of heart failure functional class, and death in the ablation/rate-control groups were 0%/7.5% (95% CI 0.05247-0.30898; p=0,006), 0%/9% (95% CI 0.08903-0.32561; p=0.001), 6%/25% (95% CI 0.147-0.894; p=0.006), and 0.02%/0%, respectively., Conclusions: In patients with long-lasting persistent AF ablation strategy results in stable SR in the majority of patients, and decreased incidence of cardiovascular events compared with rate-control strategy during up to 5 years of follow-up.
- Published
- 2013
43. Subcutaneous chronic implantable defibrillation systems in humans.
- Author
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Cappato R, Smith WM, Hood MA, Crozier IG, Jordaens L, Spitzer SG, Ardashev AV, Boersma L, Lupo P, Grace AA, and Bardy GH
- Subjects
- Electrocardiography, Electrodes, Implanted, Equipment Design, Humans, Ventricular Fibrillation physiopathology, Defibrillators, Implantable, Electric Countershock instrumentation, Ventricular Fibrillation therapy
- Abstract
The recent introduction of subcutaneous implantable cardioverter defibrillator (S-ICD) has raised attention about the potential of this technology for clinical use in daily clinical practice. We review the methods and results of the four studies conducted in humans for approval of this innovative technology for daily practice. Two studies using a temporary S-ICD system (acute human studies) were conducted to search for an appropriate lead configuration and energy requirements. For this purpose, 4 S-ICD configurations were tested in 78 patients at the time of transvenous (TV)-ICD implantation. The optimal configuration was tested in 49 more patients to comparatively assess the subcutaneous defibrillation threshold (S-DFT) versus the standard TV-ICD. Long-term implants were evaluated in 55 patients using an implanted system (chronic human study). The acute humans studies led to an optimal S-ICD configuration comprising a parasternal electrode and left anterolateral thoracic pulse generator. Both configurations successfully terminated 98% of induced ventricular fibrillation (VF), but significantly higher energy levels were required with S-ICD than with TV-ICD systems (36.6 ± 19.8 J vs. 11.1 ± 8.5 J). In the chronic study, all 137 VF episodes induced at time of implant were detected with a 98% conversion rate. Two pocket infections and four lead revisions were required during 10 ± 1 months of follow-up. During this period, survival was 98%, and 12 spontaneous ventricular tachyarrhythmias were detected and treated by the device. These data show that the S-ICD systems here consistently detected and converted VF induced at time of implant as well as sustained ventricular tachyarrhythmias occurring during follow-up (248).
- Published
- 2012
- Full Text
- View/download PDF
44. [Evaluation of the radiofrequency ablation effectiveness in patients with the Wolff-Parkinson-White syndrome].
- Author
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Ushakov IB, Ardashev AV, Ardashev VN, Voronkov IuI, Sharoĭko MV, and Akimova OS
- Subjects
- Adolescent, Adult, Electrocardiography, Electrocardiography, Ambulatory, Female, Heart physiopathology, Heart Rate, Humans, Male, Middle Aged, Prospective Studies, Treatment Outcome, Wolff-Parkinson-White Syndrome physiopathology, Wolff-Parkinson-White Syndrome surgery, Catheter Ablation, Wolff-Parkinson-White Syndrome therapy
- Abstract
A one-year prospective study involved 22 patients with the Wolff-Parkinson-White syndrome (WPW) and 20 healthy people. Means age of patients was 34.3 +/- 16.3 years. All 22 patients were successfully treated with radiofrequency ablation (RFA) of additional pathways. RFA effectiveness was evaluated with the help of clinical questionnaire, data of ECG, EchoCG, heart rate variability (HRV), frequency response and nonlinear dynamics. Cardiac rhythm disturbances were verified using Holter monitoring applied to all patients. Positive clinical effect was achieved in all the WPW patients, as RFA arrested cardiac arrhythmias completely. Holter monitoring did not register cardiac disturbances which points to high RFA effectiveness in WPW patients. HRV, frequency response and nonlinear dynamics reassumed their normal patterns.
- Published
- 2012
45. [Comparison of the effectiveness of pulmonary veins isolation vs linear radiofrequency ablation in paroxysmal atrial fibrillation patients using either mathematical scanning or clinical approach].
- Author
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Ardashev AV, Mazurov ME, Kaliuzhnyĭ IM, Zheliakov EG, and Belenkov IuN
- Subjects
- Adult, Anti-Arrhythmia Agents therapeutic use, Computer Simulation, Female, Heart Atria physiopathology, Heart Conduction System physiopathology, Heart Rate, Humans, Male, Mathematical Computing, Middle Aged, Models, Cardiovascular, Pulmonary Veins physiopathology, Research Design, Secondary Prevention, Treatment Outcome, Atrial Fibrillation physiopathology, Atrial Fibrillation surgery, Catheter Ablation adverse effects, Catheter Ablation instrumentation, Catheter Ablation methods, Heart Atria surgery, Heart Conduction System surgery, Postoperative Complications prevention & control, Pulmonary Veins surgery
- Abstract
Aim: to compare clinical results of linear ablation vs. PVI approach in patients with paroxysmal AF and to estimate theoretical probability of 4-waves re-entry to eliminate as a results of the both ablative techniques formatting by means left atrial geometry two-dimensional mathematical modeling., Material and Methods: Clinical phase. Study was conducted on 20 pts (6 women, 51,4±13,6 years of age) with paroxysmal AF underwent index RFA. All pts were divided into two age-sex-arrhythmia history duration-antiarrhythmic drugs (AAD)-matched groups. The first group consisted of 10 pts (3 women, mean age - 51,1±11,9, history of arrhythmia - 3,2±1,2 years) in whom ablation strategy consisted of PVI using LASSO technique. The second group concluded of 10 pts (3 women, mean age - 51,1±12,9, history of arrhythmia- 3,1±1,1 years) in whom ablation strategy consisted of wide-area circumferential lines application around pulmonary veins, combined to roof line and mitral isthmus RFA using three-dimensional mapping system. Mathematical phase. As the first step numeric reconstruction of the autowave process in excitable tissues of the left atrium and the simulation of AF was performed. Fitzhugh-Nagumo equation was used for simulation to enabled us to take into account the electrical inhomogeneity of the atria (pulmonary vein ostia). A special scanning method was used for calculating characteristics of autowave processes in a two-dimensional mathematical model of the atrium. As the second step simulation of circular (corresponding to LASSO approach) and linear ablation (corresponding to 3D approach) was performed., Results: Clinical phase. There were no complications associated with RFA. 7 pts of the first group vs 4 pts of the second subgroup had early recurrences of arrhythmia. AAD free sinus rhythm incidence in the first/second groups was 80%/20% at 12 months respectively (p=0,003). Mathematical phase. While circular LASSO-like ablation pattern was used, there was no elimination of 4-waves re-entry turning around the pulmonary veins ostia and vortex waves caused by them in a distributed two-dimensional atrial medium after time period equal to the re-entry period. Thus, the circular ablation formatting does not affect peripulmonary veins re-entry and, therefore, does not suppress AF. In contrast, linear ablation patterns suppress arrhythmias caused by 4-waves re-entry in two-dimensional mathematical modeling of the left atrium., Conclusion: Mathematical approach using linear ablation to simulate suppressed 4-waves re-entry more effectively comparing to PVI only. Clinical results are consistent with ablation formatting data obtained by means of 4-waves re-entry simulation in a two-dimensional mathematical modeling of the left atrium.
- Published
- 2012
46. [Comparison of effectiveness of radiofrequency catheter ablation of left arterial isthmuses for treatment of postablational perimitral atrial flutter].
- Author
-
Zheliakov EG, Ardashev AV, and Belenkov IuN
- Subjects
- Aged, Epicardial Mapping, Female, Heart Atria physiopathology, Humans, Male, Middle Aged, Pulmonary Veins surgery, Remission Induction methods, Secondary Prevention, Treatment Outcome, Atrial Fibrillation physiopathology, Atrial Fibrillation surgery, Atrial Flutter etiology, Atrial Flutter physiopathology, Atrial Flutter surgery, Catheter Ablation adverse effects, Catheter Ablation methods, Endocardium physiopathology, Endocardium surgery, Heart Atria surgery, Pericardium physiopathology, Pericardium surgery, Postoperative Complications
- Abstract
Aim: To compare results of radiofrequency (RF) ablation (A) of mitral and inferior septal isthmuses in the left atrium for the treatment of perimitral atrial flutter (AF) in patients with atrial fibrillation previously subjected to RF isolation of pulmonary veins and modification of the left atrial anatomical arrhythmia substrate., Material and Methods: We treated 20 patients (3 women, mean age 57.1+/-9.3 years) with recurrent postablational perimitral AF verified by 3-dimensional reconstruction of left and right atrial activation by nonfluoroscopic mapping and pacing techniques of entrainment into tachycardia cycle. At first stage RFA was carried out in the region of mitral isthmus (its endocardial parts). At second stage RFA was performed in the region of coronary sinus (CS) roof (epicardial portions of the mitral isthmus). At the third stage RFA influences were applied in the region of inferior septal isthmus (endocardial portions of the inferioseptal isthmus). At the fourth stage RFA was applied in the region of roof of proximal CS (epicardial portions of inferioseptal isthmus)., Results: Application of RF influences to endocardial parts of the mitral isthmus resulted in sinus rhythm (SR) restoration in 6 cases. Change of length of the tachycardia cycle was noted in 5cases. SR restoration was observed after RFA in the region of the roof of distal CS in 3 cases and change of length of the tachycardia cycle was noted in 2 more cases. RFA of epicardial parts of the inferioseptal isthmus resulted in SR restoration in 3 cases and in increase of atypical AF cycle length in 6 cases. In 12 cases SR was restored during RFA application in the region of the roof of proximal CS parts. RF influences in the region of endocardial (stage 1) and epicardial (stage 2) parts of the mitral isthmus resulted in SR restoration in 9 cases while continuation of RFA in the region of endocardial (stage 3) and epicardial (stage 4) parts of the inferioseptal isthmus led to SR restoration in the remaining 15 cases (p<0.05)., Conclusion: RFA of endocardial and epicardial parts of the inferioseptal isthmus significantly more often led to termination of perimitral atypical AF in patients previously operated because of atrial fibrillation.
- Published
- 2012
47. [The rare case of Bland-White-Garland syndrome in adult patient].
- Author
-
Alekseeva IuM, Potievskaia VI, Sakovich EA, Sitnikov AV, Soiustova EL, Fin'ko VA, and Ardashev AV
- Subjects
- Adult, Benzazepines administration & dosage, Cardiovascular Agents administration & dosage, Female, Heart Failure etiology, Humans, Ivabradine, Metoprolol administration & dosage, Mitral Valve Insufficiency etiology, Prognosis, Syndrome, Treatment Outcome, Cardiovascular Surgical Procedures methods, Coronary Angiography methods, Coronary Vessel Anomalies complications, Coronary Vessel Anomalies diagnosis, Coronary Vessel Anomalies physiopathology, Coronary Vessel Anomalies therapy, Coronary Vessels physiopathology, Coronary Vessels surgery, Multidetector Computed Tomography methods, Pulmonary Artery physiopathology, Pulmonary Artery surgery
- Abstract
We present analysis of a case history of a patient with rare congenital heart disorder - Bland-White-Garland syndrome. The 25 years old women was first diagnosed with this disorder during an examination in the cardiological department of the Moscow clinical hospital No83. The paper contains discussion of difficulties of diagnosis and peculiarities of management of adults with this pathology as well as of a problem of the choice of further therapeutic approaches.
- Published
- 2012
48. [Parameters of central hemodynamics in patients with typical atrial flutter before and after radiofrequency catheter ablation].
- Author
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Rybachenko MS, Belenkov IuN, Ardashev VN, Zheliakov EG, Konev AV, Kuzovlev OP, and Ardashev AV
- Subjects
- Adult, Aged, Echocardiography, Electrocardiography, Female, Follow-Up Studies, Humans, Male, Middle Aged, Recurrence, Treatment Outcome, Atrial Flutter diagnosis, Atrial Flutter physiopathology, Atrial Flutter therapy, Cardiovascular System physiopathology, Catheter Ablation, Hemodynamics
- Abstract
We present here results of dynamic assessment of morphofunctional state of the myocardium by the method of transthoracic echocardiography (EchoCG) in patients with paroxysmal and chronic forms of typical atrial flutter (AF) before and during one year after radiofrequency catheter ablation (RFA) of cavo-tricuspid isthmus, and comparison of them with analogous parameters in a group of healthy volunteers. Eighty six patients participated in the study. Group 1 comprised 48 patients suffering from paroxysmal form of typical AF including 42 (87.5%) men, 6 (12.5%) women (mean age 50.9+/-18.1 years). Group 2 consisted of 18 patients with permanent form of typical AF including 16 (88.9%) men and 2 (11.1%) women (mean age 53.6+/-9.4 years). The group of clinical comparison comprised 20 practically healthy persons (mean age 41.9+/-5.3 years) without structural pathology from the side of cardiovascular system including 15 (75.0%) men and 5 (25.0%) women. All group 1 and 2 patients were subjected to RFA of typical AF. In patients of groups 1 and 2 EchoCG was carried out before and in 2, 6, and 12 months after operation of RFA, in control group--once. Analysis of parameters of central hemodynamicas in patients with typical AF detected significantly lowered values of characteristics of myocardial contractile function compared with the group of practically healthy subjects. But these parameters did not differ significantly between patients with different variants of clinical course of arrhythmia. It was established that in patients with typical AF in 2 months after conduct of procedure significant improvement of myocardial inotropic function and diminishment of dimensions of cardiac chambers was noted. In 6 months after fulfilled RFA values of investigated parameters approximated analogous parameters in the group of clinical comparison.
- Published
- 2011
49. [Echocardiographic parameters in patients with Wolf-Parkinson-White syndrome before and during one year after radiofrequency catheter ablation of accessory atrioventricular junction].
- Author
-
Belenkov IuN, Rybachenko MS, Zheliakov EG, Konev AV, Ardashev AV, and Butaev TD
- Subjects
- Adult, Atrioventricular Node pathology, Atrioventricular Node physiopathology, Electrocardiography, Episode of Care, Female, Hemodynamics, Humans, Male, Middle Aged, Quality of Life, Time Factors, Treatment Outcome, Atrioventricular Node radiation effects, Catheter Ablation adverse effects, Echocardiography, Myocardium pathology, Wolff-Parkinson-White Syndrome diagnosis, Wolff-Parkinson-White Syndrome physiopathology, Wolff-Parkinson-White Syndrome therapy
- Abstract
We present in this paper results of assessment of morphofunctional state of myocardium in patients with the Wolf-Parkinson-White syndrome before and during one year after radiofrequency catheter ablation (RFA) of accessory atrioventricular junction (AAVJ) and comparison of them with analogous parameters of the group of healthy volunteers as well as in dependence on electrophysiological properties of AAVJ and its localization. One hundred sixty patients took part in the conducted study: main group comprised 160 patients (80.7%) with WPW syndrome (114 men [81.4%], 26 women [18.6%], mean age 39.5+/-15.3 years), comparison group comprised 20 practically healthy persons (15 men [75.0%], 5 women [25%], mean age 41.9+/-5.3 years). All main group patients were subjected to endocardial electrophysiological investigation and RFA of AAVJ. Transthoracic echocardiography (EchoCG) was carried out in patients of main group before and in 2, 6, and 12 months after operation of RFA of AAVJ, and once in control group. Analysis of parameters of central hemodynamics according to data of transthoracic EchoCG in patients with WPW syndrome before RFA of AAVJ demonstrated that before conduct of operative intervention no significant differences were revealed in the studied parameters compared with analogous characteristics of the clinical comparison group. During whole period of dynamic observation (2, 6, and 12 months after fulfilled RFA of AAVJ) in patients with WPW syndrome the studied parameters of central hemodynamics did not undergo substantial changes compared with initial characteristics. We failed to establish significant differences of EchoCG parameters in patients with WPW syndrome in dependence on electrophysiological properties of AAVJ (concealed, manifest) and on AAVJ localization (right, left, septal). According to EchoCG data in patients with WPW syndrome so called "minor" anomalies of development of connective tissue of the heart were diagnosed in 69 (49.3%) patients while in control group - in 2 (10%) patients.
- Published
- 2011
50. [Antitachycardia pacing in patients with implanted cardioverter defibrillators].
- Author
-
Ardashev AV, Dzhandzhgava AO, and Zheliakov EG
- Subjects
- Adolescent, Adult, Death, Sudden, Cardiac etiology, Electrocardiography, Equipment Safety, Female, Heart Rate, Humans, Male, Middle Aged, Myocardial Ischemia diagnosis, Myocardial Ischemia physiopathology, Risk Factors, Treatment Outcome, Death, Sudden, Cardiac prevention & control, Defibrillators, Implantable standards, Electric Countershock instrumentation, Electric Countershock methods, Electric Countershock statistics & numerical data, Myocardial Ischemia complications, Tachycardia, Ventricular diagnosis, Tachycardia, Ventricular epidemiology, Tachycardia, Ventricular etiology, Tachycardia, Ventricular physiopathology, Tachycardia, Ventricular therapy
- Abstract
Efficacy and safety of the use of antitachycardia pacing (ATP) function in 54 patients (age 18-54, mean age 62.2 +/- 11.5 years, 6 women) with cardioverter defibrillators implanted for prevention of sudden death. Duration of follow-up was 6-64 months (mean 27.3 +/- 8.6 months). Ischemic heart disease (IHD) was etiopathogenetic basis for development of ventricular rhythm disturbances in 38 (70.4%) patients. Arrhythmogenic right ventricular dysplasia (ARVD) was diagnosed in 8 (14.8%), hypertrophic cardiomyopathy--in 3, dilated cardiomyopathy--in 2, the Brugada syndrome--in 2 patients, and long QT syndrome--in 1 patient. Three regimens of ATP were studied--burst, ramp, ramp(+)--which were activated in 22 patients (17 with IHD and 5 with ARVD). We registered 776 episodes of ATP occurring because of ventricular tachycardia (VT) in 20 of 22 patients with activated ATP. Overall efficacy of burst ATP was 49.1%; VT was not terminated or was accelerated in 43.2 and 7.6% of cases, respectively. Ramp ATP was effective in 44.3, ineffective--in 33.9, and caused VT acceleration in 21.8% of cases, what called forth fulfillment as a next step of shock therapy (cardioversion or defibrillation). ATP led to successful termination of VT in 67.5% of patients with IHD and to acceleration of arrhythmia--in 6% of episodes. Most effective type was ramp ATP which effectively terminated VT in 76.3% of cases, while efficacy of burst ATP was 61.4% (p < 0.01). In patients with ARVD total efficacy of ATP was 25%, acceleration of VT during ATP was observed in 24% of cases; optimal was burst ATP, which efficacy was 33.9%--significantly higher than efficacy of ramp and ramp+ ATP (19.4 and 24.4%, respectively, p < 0.005).
- Published
- 2011
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