PP.36.17

Abstract

Objective: To study the influence of arterial hypertension (AH) on the effectiveness of electrical cardioversion methods, which include transesophageal electrical cardiac stimulation (ECS) and external cardioversion (EIT) in atrial flutter (AF) I type in patients with coronary heart disease (CHD). Design and method: 107 patients were examined with CHD and type I AF. The average age of the patients was 62 ± 8,3 years. AH was recorded in 63 patients. In patients with hypertension blood pressure before cardioversion was stabilized below 150/90 mm Hg. Design and method: For relief of AF we used external EIT (43%), transesophageal pacemaker (57%). If ECS was not effective intravenously amiodarone 150 mg was administered in 10–15 minutes to attempt to restore sinus rhythm and afterwards the procedure was repeated. Results: The effectiveness of electrical methods of cardioversion of AF type I were comparable - with the help of the external EIT rhythm was restored in 87% of cases, and transesophageal pacemaker after administration of amiodarone led to normalization of sinus rhythm in 90% of patients. However, in patients with hypertension were showed a significant decrease in the efficiency of cardioversion - the restoration of sinus rhythm was achieved with the help of EIT in 71% of cases, and transesophageal ECS - 69%. Conclusions: The AH is an independent factor in reducing the likelihood of recovery of sinus rhythm with using the most effective conservative methods of treatment of AF type I (external EIT and transesophageal ECS) in patients with coronary artery disease.