REAL CLINICAL PRACTICE OF TREATMENT OF CARDIAC ARRHYTHMIAS IN LOCOMOTIVE CREW WORKERS

Abstract

Cardiac arrhythmias create prerequisites for the occurrence of sudden cardiac death in the workplace, which poses a threat to the safety of train traffic. A targeted examination of locomotive crew workers (LCW) includes the diagnosis of cardiac arrhythmias for effective and safe pharmacotherapy. A retrospective analysis of 100 medical histories of machinists and assistant machinists hospitalized in the cardiology department of the Private healthcare institution "Clinical Hospital "Russian Railways-medicine" Voronezh", who have the following types of cardiac arrhythmias: supraventricular extrasystole (single 94%, paired 20%), single ventricular extrasystole 51%, paroxysmal form of atrial fibrillation 2%, conduction disorder 6%. According to the results of the examination, a group of LCW with prognostically unfavorable cardiac arrhythmias (32%) was identified, who underwent pharmacotherapy, including beta-blockers, antiarrhythmic drugs of class IC and class III. The choice of medications for pharmacotherapy in outpatient settings took into account the impact on professionally important functions according to the established List of "Medicines and traffic safety" (ed. from 2016). At discharge, 25% of patients were recommended nebivolol, which LCW could take in conditions of professional activity. Pharmacotherapy of drivers on an outpatient basis was continued with etacizine (3%), allapinine (2%), amiodarone (1%) with suspension from work for the period of taking the drug.