Abstract
Background. Atrial Fibrillation is one of the most common arrhythmias. Despite the different attitude to the pharmacotherapy of Atrial Fibrillation, the problem of selection of adequate antiarrhythmic therapy for the prevention and treatment of persistent Atrial Fibrillation remains relevant and is of great interest to researchers. For the effective selection of drugs in the treatment of arrhythmia can be successfully used the method of spectral analysis of heart rhythm variability. Aims: to study the effect of antiarrhythmic drug Sotalol and β-adrenoblocker Bisoprolol on the spectral parameters of heart rhythm variability in patients with Atrial Fibrillation. Methods. 167 patients with Atrial Fibrillation of both sexes aged 46 to 94 years were examined. The study included patients with the first diagnosed Atrial Fibrillation, and with persistent Atrial Fibrillation during of 6 months to 8 years. Arterial hypertension has diagnosed in all patients. Also, patients were diagnosed with coronary heart disease with a history of myocardial infarction and without myocardial infarction. Spectral analysis of heart rhythm variability was conducted in patients with Atrial Fibrillation. Therapy in patients was performed with the antiarrhythmic drug Sotalol (80−160 mg, orally) and Bisoprolol (2.5−5 mg, orally). Results. Spectral analysis of heart rhythm variability in patients Atrial Fibrillation using Sotalol showed that the proportion of VLF in patients with the first diagnosed Atrial Fibrillation is more than half of the spectrum, whereas in patients with persistent Atrial Fibrillation this parameter is 18%, the proportion of LF is higher in patients with persistent Atrial Fibrillation. The coefficient LF/HF in patients with persistent Arial Fibrillation is two times lower than in patients with the first diagnosed Atrial Fibrillation. Spectral analysis of heart rhythm variability in patients Atrial Fibrillation using Bisoprolol, it was shown that the proportion of LF in patients with the first diagnosed Atrial Fibrillation was 2 times lower, and the proportion of HF was twice higher than in patients with persistent Atrial Fibrillation. Conclusions. In this study, a spectral analysis of heart rate variability in patients with Atrial Fibrillation, who receive antiarrhythmic drug therapy with sotalol and bisoprolol, was carried out. It was found that humoral factors play a significant role in patients with the first diagnosed Atrial Fibrillation during sotalol therapy, the role of the vagus in this group of patients is minimal, while in patients with bisoprolol therapy the vagus has a dominant effect on the activity of the heart.
Highlights
Atrial Fibrillation is one of the most common arrhythmias
Spectral analysis of heart rhythm variability was conducted in patients with Atrial Fibrillation
Therapy in patients was performed with the antiarrhythmic drug Sotalol (80−160 mg, orally) and Bisoprolol (2.5−5 mg, orally)
Summary
Для эффективного подбора лекарственных препаратов при аритмиях можно использовать метод спектрального анализа вариабельности сердечного ритма. Цель исследования ― изучение влияния антиаритмического препарата соталола и β-адреноблокатора бисопролола на спектральные показатели вариабельности сердечного ритма у пациентов с фибрилляцией предсердий. В исследование были включены пациенты как с впервые выявленной фибрилляцией предсердий, так и имеющие давность заболевания от 6 мес до 8 лет (персистирующая форма). (Для цитирования: Попова Е.П., Богова О.Т., Чандирли С.А., Шуэб А.А., Пузин С.Н., Сычёв Д.А., Фисенко В.П. Спектральный анализ вариабельности сердечного ритма у пациентов с фибрилляцией предсердий на фоне применения соталола и бисопролола. Цель исследования ― изучить влияние антиаритмического препарата III класса соталола и β-адреноблокатора бисопролола на спектральные показатели вариабельности сердечного ритма у пациентов с ФП с целью выявления изменений в разных отделах вегетативной нервной системы, преимущественно участвующих в хронотропной функции сердца. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation 2 Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian
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