卷 4, 编号 1 (2024)

This article provides the experience of examination and treatment of paroxysmal atrial fibrillation patients with concomitant obesity, arterial hypertension and/or ischemic heart disease, who were prescribed levocarnitine in addition to traditional therapy. The addition of levocarnitine in management of atrial fibrillation was found to be capable of reducing the atrial fibrillation burden after cardioversion and improve the functional state of the patients.

The given article describes the first experience of a thoracoscopic isolation of pulmonary veins and left atrial appendage excision in the North-Western State Medical University named after I.I. Mechnikov. The clinical case features a woman with a long history of paroxysmal atrial fibrillation, severe left atrium dilation, failure in a pace control drug therapy and no effect of radiofrequency catheter isolation of pulmonary veins.

Additionally, there outlined the advantages and the significance of employing the method of thoracoscopic ablation in patients with symptomatic paroxysmal and long-term persistent atrial fibrillation, — in case if antiarrythmic drugs and radiofrequency catheter ablation proved ineffective, as well as in patients with a long-term persistent atrial fibrillation along with a severe left atrium dilation.

The article presents a clinical case of a rather rare course of hypertrophic cardiomyopathy with the transformation of a hypertrophic phenotype into a dilated phenotype against the background of the “burned-out phase” phenomenon, ventricular and supraventricular rhythm disturbances, and multiple genetic mutations. Timely started disease-modifying therapy (quadruple therapy) for chronic heart failure led to reverse positive remodeling of the left chambers of the heart.