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Siberian Journal of Clinical and Experimental Medicine

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Effectiveness of atrial fibrillation ablation in the presence of chronic myocarditis

https://doi.org/10.29001/2073-8552-2023-38-4-97-105

Abstract

Aim: To compare the effectiveness of interventional treatment of atrial fibrillation (AF) in patients with chronic myocarditis identified by endomyocardial biopsy and in patients without myocarditis.

Material and Methods. The study sample included 40 patients. Of these, 27 (67.5%) are men. The age in the sample was 49 (44; 55) years. The study included 25 (62.5%) patients with paroxysmal AF, 10 (25.0%) with persistent and 5 (12.5%) with long-term persistent. All patients underwent surgical treatment of AF using radiofrequency ablation (RFA) or cryoablation (CA). Endomyocardial biopsy was performed in 18 patients to verify the diagnosis. The follow-up period for patients was 12 months.

Results. All patients underwent surgical treatment of AF, in 7 cases (17.5%) CA of the left ventricle (LV) was performed; in 33 (82.5%) cases RFA was performed. According to the biopsy results, signs of myocarditis were detected in 9 patients (22.5%). Focal myocarditis was found in 7 patients, diffuse – in 2. The effectiveness of catheter treatment in general was 72.5%, for CA – 71.5%, for RFA 73.5%. The effectiveness of AF ablation with the presence of detected myocarditis was 88.9%, without myocarditis – 67.5%.

Conclusions. The effectiveness of catheter treatment of AF in patients with signs of myocarditis was 88.9% and was higher than in patients without signs of myocarditis.

About the Authors

E. A. Archakov
Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation

Evgenii A. Archakov, Cand. Sci. (Med.), Research Scientist, Laboratory of High Technologies for Diagnosis and Treatment of Cardiac Arrhythmias

111a, Kievskaya str., Tomsk, 634012



R. E. Batalov
Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation

Roman E. Batalov, Dr. Sci. (Med.), Head of the Laboratory of High Technologies for Diagnosis and Treatment of Cardiac Arrhythmias

111a, Kievskaya str., Tomsk, 634012



S. U. Usenkov
Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation

Stanislav U. Usenkov, Cand. Sci. (Med.), Doctor for Endovascular Diagnostics and Treatment, Laboratory of High Technologies for Diagnosis and Treatment of Cardiac Arrhythmias

111a, Kievskaya str., Tomsk, 634012



I. V. Stepanov
Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation

Ivan V. Stepanov, Cand. Sci. (Med.), Pathologist, Head of the Pathoanatomical Department

111a, Kievskaya str., Tomsk, 634012

 



S. A. Afanasiev
Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation

Sergey A. Afanasiev, Dr. Sci. (Med.), Professor, Head of the Laboratory of Molecular Cell Pathology and Genodiagnostics

111a, Kievskaya str., Tomsk, 634012



S. V. Popov
Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation

Sergey V. Popov, Dr. Sci. (Med.), Professor, Academician of the Russian Academy of Sciences, Director of the Cardiology Research Institute

111a, Kievskaya str., Tomsk, 634012



References

1. Kirgizova M.A., Eshmatov O.R., Bogdanov Yu.I., Batalov R.E., Popov S.V. Antithrombotic therapy in patients with coronary heart disease and atrial fibrillation after direct myocardial revascularization. The Siberian Journal of Clinical and Experimental Medicine. 2020;35(4):49– 56. (In Russ.). DOI: 10.29001/2073-8552-2020-35-4-49-56.

2. Arutyunov G.P., Paleev F.N., Moiseeva O.M., Dragunov D.O., Sokolova A.V., Arutyunov A.G. et al. Myocarditis in adults. Clinical guidelines 2020. Russian Journal of Cardiology. 2021;26(11):4790. (In Russ.) DOI: 10.15829/1560-4071-2021-4790.

3. Muslimova E., Rebrova T., Kondratieva D., Korepanov V., Sonduev E., Kozlov B. et al. Expression of the β1-adrenergic receptor (ADRB1) gene in the myocardium and β-adrenergic reactivity of the body in patients with a history of myocardium infraction. Gene. 2022;844:146820. DOI: 10.1016/j.gene.2022.146820.

4. Basso C., Calabrese F., Angelini A., Carturan E., Thiene G. Classification and histological, immunohistochemical, and molecular diagnosis of inflammatory myocardial disease. Heart Fail. Rev. 2013;18(6):673–681. DOI: 10.1007/s10741-012-9355-6.

5. Caforio A.L., Pankuweit S., Arbustini E., Basso C., Gimeno-Blanes J., Felix S.B. et al. European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur. Heart J. 2013;34(33):2636– 2648. DOI: 10.1093/eurheartj/eht210.

6. Mitrofanova L.B., Orshanskaya V., Ho S.Y., Platonov P.G. Histological evidence of inflammatory reaction associated with fibrosis in the atrial and ventricular walls in a case-control study of patients with history of atrial fibrillation. Europace. 2016;18(Suppl. 4):iv156–iv162. DOI: 10.1093/europace/euw361.

7. Ichiki T., Huntley B.K., Sangaralingham S.J., Harty G.J., Burnett J.C. Atrium fibrosis and inflammation: impaired atrial natriuretic peptide system in experimental heart failure. Circulation. 2014;130(Suppl. 2):A12651. DOI: 10.1161/circ.130.suppl_2.12651.

8. Matsumori A. Management of atrial fibrillation using immunoglobulin free light chains, novel biomarkers of inflammation. Eur. Cardiol. 2022;17:e22. DOI: 10.15420/ecr.2022.30.

9. Kugler S., Onodi Z., Ruppert M., Sayour A.A., Oláh A., Benke K. et al. Inflammasome activation in end-stage heart failure-associated atrial fibrillation. ESC Heart Fail. 2022;9:2747–2752. DOI: 10.1002/ehf2.13972.

10. Li N., Brundel B.J.J.M. Inflammasomes and proteostasis novel molecular mechanisms associated with atrial fibrillation. Circ. Res. 2020;127:73– 90. DOI: 10.1161/CIRCRESAHA.119.316364.

11. Weymann A., Popov A.F., Sabashnikov A., Ali-Hasan-Al-Saegh S., Ryazanov M., Tse G., Mirhosseini S.J. et al. Baseline and postoperative levels of C-reactive protein and interleukins as inflammatory predictors of atrial fibrillation following cardiac surgery: a systematic review and meta-analysis. Kardiol. Pol. 2018;76:440–451. DOI: 10.5603/KP.a2017.0242.

12. Shelemekhov A.E., Batalov R.E., Rogovskaya Yu.V., Usenkov S., Archakov Y., Gusakova A. et al. Clinical effectiveness of catheter treatment of atrial fibrillation depending on the dynamics of histological changes in the myocardium according to the results of endomyocardial biopsy of the right ventricle. Circulatory pathology and cardiac surgery. 2020;24(3):90–106. (In Russ.). DOI: 10.21688/1681-34722020-3-90-106.

13. Batalov R.E., Khlynin M.S., Rogovskaya Y.V., Sazonova S.I., Tatarskiy R.B., Anfinogenova N. et al. Isolated atrial fibrillation, inflammation and efficacy of radiofrequency ablation: Preliminary insights based on a single-center endomyocardial biopsy study. J. Clin. Med. 2023;12(4):1254. DOI: 10.3390/jcm12041254.


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For citations:


Archakov E.A., Batalov R.E., Usenkov S.U., Stepanov I.V., Afanasiev S.A., Popov S.V. Effectiveness of atrial fibrillation ablation in the presence of chronic myocarditis. Siberian Journal of Clinical and Experimental Medicine. 2023;38(4):97-105. (In Russ.) https://doi.org/10.29001/2073-8552-2023-38-4-97-105

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ISSN 2713-2927 (Print)
ISSN 2713-265X (Online)