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Aim. To evaluate the efficacy of CCAPC in complex treatment of the patients with multifocal atherosclerosis and involvement of the heart and lower extremities arteries.Material and methods. Totally 74 patients included (66 men and 8 women), mean age 63,2±9,3 y.: 32 (43%) with IIa stage and 42 (57%) with IIb stage of lower extremities ischemia; 58 (80%) with II functional class of angina and 16 (20%) with III functional class (by CCS). CCAPC was performed on a “CARDIOPULSAR” software-hardware complex. The protocol of the study consisted in 30 procedures by 60 min. per day. Efficacy of CCAPC was assessed by the changes in EchoCG, 6-minute walking test, DPW, ABI, LDF, activity index DASI, Edinburgh questionnaire of intermittent claudication.Results. The regression of clinical symptoms was found in all patients after the treatment by CCAPC in cardiosynchronized angioregimen: the significant increase of exercise tolerance was found as DPW, ABI, DASI values, microcirculation parameters by LDF. The assessment of EchoCG parameters (EDS, ESS, EDV, ESV, LVEF) and functional class of angina revealed that after the course of CCAPC coronary blood flow did not change significantly. All patients had a subjective improvement: physical activities increased, dyscomfort in lower extremities decreased as the feelings of chills and cold.Conclusion. CCAPC is a novel important non-invasive effective and safe method of multifocal atherosclerosis treatment involving the heart and lower extremities vessels.

The article contains data on the influence of programmed hemodialysis on the structure and incidence of supraventricular and ventricular arrhythmias in patients with end stage chronic renal failure. 67 patients have been studied with the usage of continuous ECG monitoring, assessment of heart rate temporary and spectral parameters before, during and after hemodialysis (n = 48) and in patients with chronic renal failure one the pre-dialysis stage (n = 19). It have been noted that hemodialysis procedures are accompanied by activation of the whole autonomous nervous system with predominant vagus influence on the heart and decreased sympathetic tone. Following hemodialysis the activity of autonomous nervous system is decreased significantly with predominant sympathetic influence on the heart increasing myocardium electric instability. Relationship between changes in heart rate variability and the development of hazardous arrhythmias, as well as with changes in electrolytes concentration, is covered.

Presents the results of the use of Bivalirudin in actual practice in patients with acute coronary syndrome during percutaneous coronary intervention (PCI). Demonstrated high efficiency of Bivalirudin in the amount of bleeding occurring in the postoperative period and adverse cardiovascular complications.