Vol 1, No 1 (2021)


The Role of Hyperuricemia in the Development of Atrial Fibrillation

Barysenka T.L., Snezhitskiy V.A.


Atrial fibrillation (AF) is one of the most common cardiac arrhythmias. We have discussed the role of hyperuricemia as a predisposing factor for the onset of AF. Numerous clinical and experimental investigators demonstrated the correlation between serum uric acid (SUA) level and arrhythmia development and its complications. The development and progression of AF are connected to a complex of changes in atrial cardiac muscle tissue. The electrical, structural, contractile remodeling, neurohumoral systems, inflammation, fibrosis, oxidative stress, endothelial dysfunction, activation of NLRP3 inflammasome induced by crystals of monosodium urate (MSU), heat shock proteins (HSP), cytokines – all have a role in the development of this process. Furthermore, the role of xanthine oxidase (XO) is considered in the pathogenesis of AF through activation of systemic inflammation and oxidative stress, preparing that substrate for AF. The overwhelming data suggest a direct pathophysiological role of the increased SUA and XO activity as risk factors for AF. This article offers a comprehensive review of investigations that shows the interrelation between hyperuricemia and the risk of AF.

Cardiac Arrhythmias. 2021;1(1):7-16
pages 7-16 views

Original Research

Application of Hemostatic Agent “Haemoblock” for Pocket Hematoma Reduction. Design of the PEGAS study: a Multicenter Clinical Trial

Nechepurenko A.A., Ilov N.N., Durmanov S.S., Shugaev P.L., Ivanchenko A.V., Suchkov I.A., Bsharat K.A., Lukin A.M., Medyanсeva L.G., Povarov V.O.


Pocket hematoma (PH) is a common complication of pacemaker implantations which prolongs hospitalization and may demand surgical revision in some cases. According to the data from different researchers PH rate varies from 2 to 7%. It depends on number of factors including a need for anticoagulation therapy. We present a review of design of multicenter clinical trial evaluating safety and efficacy of application of hemostatic agent “Haemoblock” for pocket hematoma reduction in patients taking oral anticoagulants.

Cardiac Arrhythmias. 2021;1(1):17-24
pages 17-24 views

Case reports

Late Electrode Sepsis: Clinical Features, Diagnostics and Management. Clinical Cases

Zimina V.Y., Airapetian G., Grishkin Y.N., Sayganov S.A.


Modern cardiology is impossible without implantation of intracardiac devices, such as cardiac pacemakers, resynchronization therapy devices, implantable cardioverter-defibrillators. Meanwhile, as the number of implanted devices increases, so does the number of cases of their infection [1]. At present, sufficient clinical material has been accumulated, demonstrating the obvious features of the course of this type of IE, leading to late diagnosis, the spread of infection to the tricuspid valve and, as a result, to a poor prognosis. The frequency of purulent complications after implantation of pacemakers is from 0.6 to 5.7%; mortality rate varies from 0.13% in local purulent inflammation to 19.9% in bacterial endocarditis and sepsis [2].

Abroad, term electrode sepsis is widely used to reflect the main features of the course of cardiac implantable electronic device infection, which are the predominance of systemic inflammation symptoms and the long-term absence of heart damage signs.

We present two typical cases of the course of cardiac implantable electronic device infection, illustrating the difficulties of diagnosing and treating this disease.

Cardiac Arrhythmias. 2021;1(1):25-32
pages 25-32 views

Nuances of Cardiac Resynchronization Therapy in Patients with Dilated Cardiomyopathy and Atrial Fibrillation (a Clinical Case)

Bitakova F.I., Gumerova V.E., Zbyshevskaya E.V., Zimina V.Y., Novikova T.N., Ratmanov R.V., Saiganov S.A., Shcherbakova V.A.


Dilated cardiomyopathy (DCM) is a steadily developing disease characterized by progressive chronic heart failure (CHF) resistant to drug therapy. Cardiac resynchronization therapy (CRT) significantly improves the prognosis in these patients if they have indications for implantation of resynchronization devices. The article presents a clinical case of successful implantation of a cardioversion-defibrillation cardiac resynchronization device in a patient suffering from DCM in combination with permanent atrial fibrillation (AF). The nuances of ventricular rate control and the role of the catheter procedure for modifying the atrioventricular junction are discussed.

Cardiac Arrhythmias. 2021;1(1):33-38
pages 33-38 views

Clinical Experience of Use of Sacubitril/Valsartan in a Patient with Dilated Cardiomyopathy, Chronic Heart Failure with Reduced Ejection Fraction and Ventricular Arrhythmias

Snezhitskiy V.A., Kalatsei L.V., Matyukevich M.C., Grib S.N., Snezhickaya E.А., Madekina G.А., Epifanova Z.G., Chernaya E.N.


Chronic heart failure is the final stage of the cardiovascular continuum, which is an important cause of disability and reduced life expectancy in developed countries. Optimal medical therapy recommended for patients with symptomatic HF and reduced left ventricular ejection fraction includes angiotensin-converting enzyme inhibitors (or angiotensin II receptor antagonists), beta-blockers and mineralocorticoid receptor antagonists. However, the use of optimal medical therapy does not always lead to the elimination of symptoms, improvement of the quality of life and functional capabilities of patients.

Sakubitril/valsartan is a novel combination drug that includes the angiotensin II receptor blocker valsartan and the neprilisin inhibitor sacubitril. In a large PARADIGM-HF clinical trial it demonstrated a 20% reduction in cardiovascular mortality and hospitalization due to decompensation of heart failure compared with standard therapy with enalapril. We report a case of successful use of sacubitril/valsartan in a 61-year-old patient with dilated cardiomyopathy, chronic heart failure with reduced ejection fraction and ventricular arrhythmias. After 6 months of therapy, the patient achieved marked positive dynamics of the clinical status, laboratory and instrumental parameters in absence of any adverse reactions and complications.

Cardiac Arrhythmias. 2021;1(1):39-48
pages 39-48 views

Postabaltive Pericarditis in Patient with a Prior History of Rheumatic Disease: a Case Report

Zhelyakov E.G., Ardashev A.V., Kocharian A.A., Ginsburg M.L., Daniels E.


A 60 year-old male with a previous (40 years ago) history of rheumatic carditis without valve involvement and 5 years history of paroxysmal atrial fibrillation underwent ablation (PV isolation with roof and mitral isthmus lines). The following day patient developed AF episode with severe mid-sternal chest pain with widespread concave ST elevation throughout most of the limb leads (I, II, III, aVL, aVF) and precordial leads (V2-6). Serum troponin I was 87.2 ng/ml with a creatinine concentration of 0.88 mg/dl and hemoglobin level of 15 g/dl. 2D transthoracic echocardiogram excluded wall motion abnormalities, or significant pericardial effusions. Recurrence of acute rheumatic fever was excluded based on revised Jones criteria. Careful analysis of ECG allowed us to recognize the ECG criteria of pericarditis and to avoid unnecessary emergent coronary angiography. Ultimately, the patient was diagnosed with pericarditis. After diagnosis, the patient’s presenting symptoms resolved with treatment including sotalol 160 mg per day, nonsteroidal anti-inflammatory agents.

Conclusions: This is the first reported case study of post-cardiac ablation pericarditis in patient with prior history of rheumatic carditis.

Cardiac Arrhythmias. 2021;1(1):49-54
pages 49-54 views

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