Vol 2, No 1 (2022)


Access Site Complications by Intracardiac Interventions

Kimkov A.V.


In recent decades, the number of intracardiac procedures using percutaneous puncture access has increased manifold. Despite the acquisition by operators of expertise and standardization of methods, the problem of complications remains relevant.

AIM: to analyze the frequency and nature of complications of percutaneous access in intracardiac interventions. Suggest recommendations to reduce the incidence of complications.

MATERIALS AND METHODS: analysis of data published in international peer-reviewed journals on the topic, as well as the experience of the vascular surgery clinic of St. Katarina's Hospital.

CONCLUSIONS: the frequency and severity of complications depend on the experience of the operator, the size and frequency of changing the instrument, as well as compliance with the rules of preoperative diagnosis and postoperative management of the patient.

RECOMMENDATIONS: standardized preoperative preparation, careful planning of the intervention, analysis of the state of the access vessels, compliance with the rules of vessel puncture and competent performance of postoperative compression in combination with the use of suturing devices according to indications can reduce the frequency and severity of complications.

Cardiac Arrhythmias. 2022;2(1):5-12
pages 5-12 views

Non-Invasive Electrophysiological Markers Associated With Long QT Syndrome

Ardashev A.V., Snezhitskiy V.A., Kalatsei L.V.


Long QT syndrome (LQTS) is a life-threatening channelopathy, characterized by permanent or transient QT interval prolongation on the 12-lead electrocardiogram and syncope associated with malignant ventricular rhythm disturbances, particularly polymorphic ventricular tachycardia also known as torsade de pointes. Corrected QT (QTc) interval measurement remains the initial source of LQTS diagnosis in any patient, but the «borderline» QTc interval prolongation should induce further investigation. Genetic testing has the greatest value to provide definitive diagnosis in such situations, but it can’t be applied to each patient routinely, putting aside that it can often be incomprehensive, costly or unavailable. The present review discusses the most promising non-invasive electrophysiological markers associated with Long QT syndrome, particularly in absence of visible QT interval prolongation and clinical manifestations.

Cardiac Arrhythmias. 2022;2(1):13-22
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Original Research

Factors of Cardiovascular Risk in Drivers of Locomotive Crews of Railway Transport with Ventricular Arrhythmias

Metso K.V., Nikiforov V.S.


AIM: This study aimed to assess cardiovascular risk factors in drivers and assistant drivers of railway engine crews with ventricular rhythm disorders.

MATERIALS AND METHODS: The study included 120 patients aged 39 to 61 years (mean age M ± SD: 50.4 ± 4 years), who were distributed into two groups with and without ventricular rhythm disorders. All participants underwent 12-lead daily ECG monitoring with assessment of noninvasive markers of myocardial electrical instability (circadian profile, QT interval, late ventricular potentials, T-wave alternation, rhythm variability). Traditional factors of cardiovascular risk, the employment period in the profession, and the level of personal and situational anxiety on Spielberger’s state-trait anxiety inventory (STAI) were evaluated.

RESULTS: In Group 1, in comparison with Group 2, significant differences were revealed in the duration of the PQ interval (during the day and at night) and the indicators of late ventricular potentials (RMS 40 and TotQRSF). When analyzing risk factors, elevated indices of total blood cholesterol were registered in both groups, and the risk on the SCORE scale was at a moderate level. In the group of workers with ventricular rhythm disorders, higher indicators of total blood cholesterol and the frequency of smoking and alcohol consumption were established. In individuals with ventricular rhythm disorders, a significant relationship was detected between the number of registered single monomorphic ventricular extrasystoles and the age of the employee (r = −0.3, р < 0.05), and blood pressure level (r = 0.3, р < 0.05), and the relationship between the level of anxiety and the registration of single supraventricular extrasystoles was established (r = −0.3, р < 0.05). In the Group 2, a significant correlation was revealed between the number of registered single supraventricular extrasystoles and age (r = 0.2, р < 0.05), the employment period in the profession of a driver (r = 0.2, р < 0.05), the blood pressure level (r = 0.2, р < 0.05), and the level of anxiety on the STAI (r = 0.3, р < 0.05).

CONCLUSIONS: Drivers of railway engine crews with ventricular rhythm disorders are characterized by a higher level of total blood cholesterol and a higher frequency of smoking and alcohol consumption. They have significant changes in the duration of the PQ interval (during the day and at night) and indicators of late ventricular potentials (RMS 40 and TotQRSF) according to Holter monitoring. The relationship of the number of ventricular rhythm disorders with age and the office values of systolic and diastolic blood pressure is noted in drivers of engine crews of railway transport.

Cardiac Arrhythmias. 2022;2(1):23-29
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Case reports

Disease-Modifying Therapy of Chronic Heart Failure on the Background of Heart Rhythm and Conductivity Disorders (Clinical Case)

Novikova T.N., Novikov V.I., Bitakova F.I., Saiganov S.A., Shcherbakova V.A.


The article presents a clinical case of the development and progression of chronic heart failure (CHF) in a patient with postinfarction cardiosclerosis after implantation of a permanent pacemaker due to binodal dysfunction. The progression of CHF was exacerbated by the patient's transition to a permanent form of atrial fibrillation. Complex therapy for CHF, including cardiac resynchronization therapy, drug therapy with valsartan + sacubitril, empagliflozin, eplerenone, metoprolol succinate (quadrotherapy) led to a complete recovery of the ejection fraction (EF) of the left ventricle. After the patient stopped taking one of the components of quadrotherapy (valsartan + sacubitril), there was a tendency to decrease in EF. The clinical case emphasizes the importance of the timely transformation of traditional permanent pacing into cardiac resynchronization therapy and the appointment of complex modern drug therapy for CHF. When an improvement or restoration of EF is achieved, it is advisable to continue the therapy against which the improvement was obtained in order to avoid the negative consequences that are possible when the components of the quadrotherapy are cancelled.

Cardiac Arrhythmias. 2022;2(1):31-40
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Catheter ablation of sustained idiopathic right ventricular outflow tract tachycardia in a pregnant patient without fluoroscopy

Govorova Y.O., Pershina E.S., Tyukov P.A., Alekhnovich A.V., Lischuk A.N., Gromyko G.A.


In 2020, our department has performed 739 operations on nonpregnant patients. Additionally, 545 highly successful nonfluoroscopic catheter ablation of cardiac arrhythmias were routinely performed using a three-dimensional navigation system, including 47 patients with idiopathic ventricular tachycardia (VT) from the right ventricular outflow tract (RVOT).

A 38-year-old female patient with a structurally normal heart was admitted to our hospital in 10–11 weeks of her third pregnancy because she sustained recurrent 166 regular heartbeats per minute, wide QRS-complex tachycardia with left bundle branch morphology, and frequent premature ventricular contractions on Holter monitoring with complaints of presyncope and dyspnea. Standard antiarrhythmic drugs failed to control tachycardia. This case report presents our initial successful experience of the rescue zero-fluoroscopy catheter ablation of sustained poorly tolerated idiopathic RVOT tachycardia in a pregnant patient. Our result suggests that this technique may be considered in the few rare cases in which drug-resistant, sustained frequent VT is accompanied by hemodynamic compromise with fluoroscopy contraindication.

AIM: Diagnostic algorithm of idiopathic sustained drug-resistant, poorly tolerated VT and the possibility of radiofrequency catheter ablation in the most vulnerable first trimester of pregnancy without fluoroscopy were presented in our case report.

Cardiac Arrhythmias. 2022;2(1):41-46
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Corrigendum to "Late Electrode Sepsis: Clinical Features, Diagnostics and Management. Clinical Cases". DOI: 10.17816/cardar71367

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


There is an error occurred in the published article “Late Electrode Sepsis: Clinical Features, Diagnostics and Management. Clinical Cases” by Vera Yu. Zimina, Gevorg R. Airapetian, Yuri N. Grishkin, Sergey A. Sayganov. Due to a technical error on author’s part and without any malicious intent, the names of the authors who were directly involved in writing the article and made a great contribution to the work were lost. The full-text of the article begins with an introduction previously partially included in the abstract of this article. The error does not change the essence of the data presented in the article, does not violate their perception by readers or interpretation.

Authors confirm the accuracy of the information provided in this letter about the composition of the team of authors, and that the contribution of each member of the authors team indicated in this letter is sufficient to be recognized as an author in accordance with the recommendations of the ICMJE.

Cardiac Arrhythmias. 2022;2(1):47-48
pages 47-48 views

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