cardiotomskСибирский журнал клинической и экспериментальной медициныSiberian Journal of Clinical and Experimental Medicine2713-29272713-265XTSU publishing10.29001/2073-8552-2016-31-3-23-26cardiotomsk-223Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESХИРУРГИЧЕСКАЯ АБЛАЦИЯ ФИБРИЛЛЯЦИИ ПРЕДСЕРДИЙ У ПАЦИЕНТОВ С ИШЕМИЧЕСКОЙ БОЛЕЗНЬЮ СЕРДЦА И КОРОНАРНЫМ ШУНТИРОВАНИЕМ: СОВРЕМЕННЫЕ НАПРАВЛЕНИЯSURGICAL ABLATION OF ATRIAL FIBRILLATION IN PATIENTS WITH CORONARY ARTERY DISEASE AND CORONARY ARTERY BYPASS GRAFTING: MODERN TRENDБогдановЮ. И.BogdanovYu. I.

аспирант отделения хирургического лечения сложных нарушений ритма сердца и электрокардиостимуляции,

634012, г. Томск, ул. Киевская, 111а

yuri-bogdanov@mail.ruПоповС. В.PopovS. V.

докт. мед. наук, профессор, член-корреспондент РАН, руководитель отделения хирургического лечения сложных нарушений ритма сердца и электрокардиостимуляции, директор,

634012, г. Томск, ул. Киевская, 111а

psv@cardio.tsu.ruВечерскийЮ. Ю.VecherskyYu. Yu.

докт. мед. наук, профессор, ведущий научный сотрудник отделения сердечно-сосудистой хирургии,

634012, г. Томск, ул. Киевская, 111а

vjj@cardio.tsu.ruБаталовР. Е.BatalovR. E.

канд. мед. наук, старший научный сотрудник отделения хирургического лечения сложных нарушений ритма сердца и электрокардиостимуляции,

634012, г. Томск, ул. Киевская, 111а

romancer@cardio.tsu.ruЗатолокинВ. В.ZatolokinV. V.

младший научный сотрудник, врач-хирург отделения сердечно-сосудистой хирургии,

634012, г. Томск, ул. Киевская, 111а

zatolokin@cardio-tomsk.ruНаучно-исследовательский институт кардиологии, Томский национальный исследовательский медицинский центр Российской академии наукРоссияCardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of SciencesRussian Federation2016041120163132326Copyright © Богданов Ю.И., Попов С.В., Вечерский Ю.Ю., Баталов Р.Е., Затолокин В.В., 20162016Богданов Ю.И., Попов С.В., Вечерский Ю.Ю., Баталов Р.Е., Затолокин В.В.Bogdanov Y.I., Popov S.V., Vechersky Y.Y., Batalov R.E., Zatolokin V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.sibjcem.ru/jour/article/view/223

Статья посвящена анализу современных методик лечения фибрилляции предсердий (ФП) у пациентов с ишемической болезнью сердца (ИБС) во время коронарного шунтирования. В статье проанализировано современное направление хирургической аблации, различные техники, методики. Дана оценка каждой из них. Обоснована необходимость оптимизации радиочастотной аблации (РЧА) у пациентов с ИБС во время коронарного шунтирования.

The article is devoted to analysis of modern methods of atrial fibrillation treatment in patients with coronary artery disease and coronary artery bypass grafting. Systematic review of various surgical ablation techniques and methods has been done in particular. The necessity for radiofrequency ablation modification is substantiated.

фибрилляция предсердийэпикардиальная аблациякоронарное шунтированиеatrial fibrillationsurgical ablationcoronary artery bypass graftingReferencesПопов С.В., Антонченко И.В., Баталов Р.Е. и др. Фибрилляция предсердий: аблация или нет // Рос. мед. журнал. – 2009. – № 18. – С. 1108–1111.Попов С.В., Антонченко И.В., Баталов Р.Е. и др. Фибрилляция предсердий: аблация или нет // Рос. мед. журнал. – 2009. – № 18. – С. 1108–1111.Мазуров М.Е., Ардашев А.В., Желяков Е.Г. и др. Сопоставление результатов математического моделирования и клинических данных при радиочастотной абляции постабляционного перимитрального трепетания предсердий: определение условий формирования перимитрального re-entry // Кардиология. – 2014. – № 4. – С. 39–45.Мазуров М.Е., Ардашев А.В., Желяков Е.Г. и др. Сопоставление результатов математического моделирования и клинических данных при радиочастотной абляции постабляционного перимитрального трепетания предсердий: определение условий формирования перимитрального re-entry // Кардиология. – 2014. – № 4. – С. 39–45.Calkins H., Kuck K.H., Cappato R. et al. 2012 HRS/EHRA/ ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow up, definitions, endpoints, and research trial design // Europace. – 2012. – Vol. 14. – P. 528–606.Calkins H., Kuck K.H., Cappato R. et al. 2012 HRS/EHRA/ ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow up, definitions, endpoints, and research trial design // Europace. – 2012. – Vol. 14. – P. 528–606.Ad N., Suri R.M., Gammie J.S. et al. Surgical ablation of atrial fibrillation trends and outcomes in North America // J. Thorac. Cardiovasc. Surg. – 2012. – Vol. 144. – P. 1051–1060.Ad N., Suri R.M., Gammie J.S. et al. Surgical ablation of atrial fibrillation trends and outcomes in North America // J. Thorac. Cardiovasc. Surg. – 2012. – Vol. 144. – P. 1051–1060.Maisel W.H., Rawn J.D., Stevenson W.G. Atrial fibrillation after cardiac surgery // Ann. Intern. Med. – 2001. – Vol. 135 – P. 1061–1073.Maisel W.H., Rawn J.D., Stevenson W.G. Atrial fibrillation after cardiac surgery // Ann. Intern. Med. – 2001. – Vol. 135 – P. 1061–1073.Mariscalco G., Klersy C., Zanobini M. et al. Atrial fibrillation after isolated coronary surgery affects late survival // Circulation. – 2008. – Vol. 118. – P. 1612–1618.Mariscalco G., Klersy C., Zanobini M. et al. Atrial fibrillation after isolated coronary surgery affects late survival // Circulation. – 2008. – Vol. 118. – P. 1612–1618.Villareal R.P., Hariharan R., Liu B.C. et al. Postoperative atrial fibrillation and mortality after coronary artery bypass surgery // J. Am. Coll. Cardiol. – 2004. – Vol. 43. – P. 742–748.Villareal R.P., Hariharan R., Liu B.C. et al. Postoperative atrial fibrillation and mortality after coronary artery bypass surgery // J. Am. Coll. Cardiol. – 2004. – Vol. 43. – P. 742–748.Borde D., Gandhe U., Hargave N. et al. Prediction of postoperative atrial fibrillation after coronary artery bypass grafting surgery: is CHA 2 DS 2 – VASc score useful? // Ann. Card. Anaesth – 2014. – Vol. 17. – P. 182–187.Borde D., Gandhe U., Hargave N. et al. Prediction of postoperative atrial fibrillation after coronary artery bypass grafting surgery: is CHA 2 DS 2 – VASc score useful? // Ann. Card. Anaesth – 2014. – Vol. 17. – P. 182–187.Mariscalco G., Engstrom K.G. Postoperative atrial fibrillation is associated with late mortality after coronary surgery, but not after valvular surgery // Ann. Thorac. Surg. – 2009. – Vol. 88. – P. 1871–1876.Mariscalco G., Engstrom K.G. Postoperative atrial fibrillation is associated with late mortality after coronary surgery, but not after valvular surgery // Ann. Thorac. Surg. – 2009. – Vol. 88. – P. 1871–1876.Almassi G.H., Pecsi S.A., Collins J.F. et al. Predictors and impact of postoperative atrial fibrillation on patients’ out comes: a report from the Randomized On Versus Off Bypass trial // J. Thorac. Cardiovasc. Surg. – 2012. – Vol. 143. – P. 93–102.Almassi G.H., Pecsi S.A., Collins J.F. et al. Predictors and impact of postoperative atrial fibrillation on patients’ out comes: a report from the Randomized On Versus Off Bypass trial // J. Thorac. Cardiovasc. Surg. – 2012. – Vol. 143. – P. 93–102.Jazayeri M.R., Hempe S.L., Sra J.S. et al. Selective transcatheter ablation of the fast and slow pathways using radiofrequency energy in patients with atrioventricular nodal reentrant tachycardia // Circulation. – 1992. – Vol. 85. – P. 1318–1328.Jazayeri M.R., Hempe S.L., Sra J.S. et al. Selective transcatheter ablation of the fast and slow pathways using radiofrequency energy in patients with atrioventricular nodal reentrant tachycardia // Circulation. – 1992. – Vol. 85. – P. 1318–1328.Hoenicke E.M., Strange R.G., Patel H. et al. Damiano. Initial experience with epicardial radiofrequency ablation catheter in an ovine model: moving towards an endoscopic maze procedure // Surg. Forum. – 2000. – Vol. 81. – P. 79–82.Hoenicke E.M., Strange R.G., Patel H. et al. Damiano. Initial experience with epicardial radiofrequency ablation catheter in an ovine model: moving towards an endoscopic maze procedure // Surg. Forum. – 2000. – Vol. 81. – P. 79–82.Vicol C., Kur F., Eifert S. et al. Bipolar irrigated radiofrequency ablation of the posterior inferior left atrium and coronary sinus is feasible and safe // Heart Surg. Forum. – 2004. – Vol. 7. – P. 535–538.Vicol C., Kur F., Eifert S. et al. Bipolar irrigated radiofrequency ablation of the posterior inferior left atrium and coronary sinus is feasible and safe // Heart Surg. Forum. – 2004. – Vol. 7. – P. 535–538.Prasad S.M., Maniar H.S., Schuessler R.B. et al. Chronic transmural atrial ablation by using bipolar radiofrequency energy on the beating heart // J. Thorac. Cardiovasc. Surg. – 2002. – Vol. 124. – P. 708–713.Prasad S.M., Maniar H.S., Schuessler R.B. et al. Chronic transmural atrial ablation by using bipolar radiofrequency energy on the beating heart // J. Thorac. Cardiovasc. Surg. – 2002. – Vol. 124. – P. 708–713.Boersma L.V.A., Castella M., van Boven WimJan et al. Atrial Fibrillation Catheter Ablation Versus Surgical Ablation Treatment (FAST) // Circulation. – 2012. – Vol. 125. – P. 23–30.Boersma L.V.A., Castella M., van Boven WimJan et al. Atrial Fibrillation Catheter Ablation Versus Surgical Ablation Treatment (FAST) // Circulation. – 2012. – Vol. 125. – P. 23–30.Sueda T., Imai K., Ishii O. et al. Efficacy of pulmonary vein isolation for the elimination of chronic atrial fibrillation in cardiac valvular surgery // Ann. Thorac. Surg. – 2001. – Vol. 71. – P. 1189–1193.Sueda T., Imai K., Ishii O. et al. Efficacy of pulmonary vein isolation for the elimination of chronic atrial fibrillation in cardiac valvular surgery // Ann. Thorac. Surg. – 2001. – Vol. 71. – P. 1189–1193.Kondo N., Takahashi K., Minakawa M. et al. Left atrial maze procedure: a useful addition to other corrective operations // Ann. Thorac. Surg. – 2003. – Vol. 75. – P. 1490–1494.Kondo N., Takahashi K., Minakawa M. et al. Left atrial maze procedure: a useful addition to other corrective operations // Ann. Thorac. Surg. – 2003. – Vol. 75. – P. 1490–1494.Geidel S., Ostermeyer J., Lass M. et al. Permanent atrial fibrillation ablation surgery in CABG and aortic valve patients is at least as effective as in mitral valve disease // Thorac. Cardiovasc. Surg. – 2006. – Vol. 54. – P. 91–95.Geidel S., Ostermeyer J., Lass M. et al. Permanent atrial fibrillation ablation surgery in CABG and aortic valve patients is at least as effective as in mitral valve disease // Thorac. Cardiovasc. Surg. – 2006. – Vol. 54. – P. 91–95.Deneke T., Khargi K., Grewe P. et al. Left atrial versus bi-atrial maze operation using intraoperatively cooled-tip radiofrequency ablation in patients undergoing open-heart surgery: Safety and efficacy // J. Am. Coll. Cardiol. – 2002. – Vol. 39. – P. 1644–1650.Deneke T., Khargi K., Grewe P. et al. Left atrial versus bi-atrial maze operation using intraoperatively cooled-tip radiofrequency ablation in patients undergoing open-heart surgery: Safety and efficacy // J. Am. Coll. Cardiol. – 2002. – Vol. 39. – P. 1644–1650.Castella M., Garcia Valentin A., Pereda D. et al. Anatomic aspects of the atrioventricular junction influencing radiofrequency Cox maze IV procedures // J. Thorac. Cardiovasc. Surg. – 2008. – Vol. 136. – P. 419–423.Castella M., Garcia Valentin A., Pereda D. et al. Anatomic aspects of the atrioventricular junction influencing radiofrequency Cox maze IV procedures // J. Thorac. Cardiovasc. Surg. – 2008. – Vol. 136. – P. 419–423.Jasbir S. Prospective, randomized comparison of hybrid ablation vs. catheter ablation [Electronic resource] // Clinical Trials. – URL: https://clinicaltrials.gov/ct2/show/NCT02344394 (дата обращения 10.06.2016).Jasbir S. Prospective, randomized comparison of hybrid ablation vs. catheter ablation [Electronic resource] // Clinical Trials. – URL: https://clinicaltrials.gov/ct2/show/NCT02344394 (дата обращения 10.06.2016).Gammie J.S., Haddad M., Milford Beland S. et al. Atrial fibrillation correction surgery: lessons from the society of thoracic surgeons national cardiac database // Ann. Thoracic. Surg. – 2008. – Vol. 85, No. 3. – P. 909–914.Gammie J.S., Haddad M., Milford Beland S. et al. Atrial fibrillation correction surgery: lessons from the society of thoracic surgeons national cardiac database // Ann. Thoracic. Surg. – 2008. – Vol. 85, No. 3. – P. 909–914.Gillinov A.M., McCarthy P.M., Blackstone E.H. et al. Surgical ablation of atrial fibrillation with bipolar radiofrequency as the primary modality // J. Thorac. Cardiovasc. Surg. – 2005. – Vol. 129. – P. 1322–1329.Gillinov A.M., McCarthy P.M., Blackstone E.H. et al. Surgical ablation of atrial fibrillation with bipolar radiofrequency as the primary modality // J. Thorac. Cardiovasc. Surg. – 2005. – Vol. 129. – P. 1322–1329.La Meir M., Gelsomino S., Nonneman B. The problem with concomitant atrial fibrillation in non mitral valve surgery // Ann. Cardiothorac. Surg. – 2014. – Vol. 3. – P. 124–129.La Meir M., Gelsomino S., Nonneman B. The problem with concomitant atrial fibrillation in non mitral valve surgery // Ann. Cardiothorac. Surg. – 2014. – Vol. 3. – P. 124–129.Gaynor S.L., Schuessler R.B., Bailey M.S. et al. Surgical treatment of atrial fibrillation: predictors of late recurrence // J. Thorac. Cardiovasc. Surg. – 2005. – Vol. 129. – P. 104–111.Gaynor S.L., Schuessler R.B., Bailey M.S. et al. Surgical treatment of atrial fibrillation: predictors of late recurrence // J. Thorac. Cardiovasc. Surg. – 2005. – Vol. 129. – P. 104–111.Echahidi N., Pibarot P., O’Hara G., Mathieu P. Mechanisms, prevention, and treatment of atrial fibrillation after cardiac surgery // J. Am. Coll. Cardiol. – 2008. – Vol. 51. – P. 793–801.Echahidi N., Pibarot P., O’Hara G., Mathieu P. Mechanisms, prevention, and treatment of atrial fibrillation after cardiac surgery // J. Am. Coll. Cardiol. – 2008. – Vol. 51. – P. 793–801.Shirzad M., Karimi A., Tazik M. et al. Determinants of postoperative atrial fibrillation and associated resource utilization in cardiac surgery // Rev. Esp. Cardiol. – 2010. – Vol. 63. – P. 1054–1060.Shirzad M., Karimi A., Tazik M. et al. Determinants of postoperative atrial fibrillation and associated resource utilization in cardiac surgery // Rev. Esp. Cardiol. – 2010. – Vol. 63. – P. 1054–1060.Robertson J.O., Saint L.L., Leidenfrost J.E. et al. Illustrated techniques for performing the Cox Maze IV procedure through a right mini thoracotomy // Ann. Cardiothorac. Surg. – 2014. – No. 3. – P. 105–116.Robertson J.O., Saint L.L., Leidenfrost J.E. et al. Illustrated techniques for performing the Cox Maze IV procedure through a right mini thoracotomy // Ann. Cardiothorac. Surg. – 2014. – No. 3. – P. 105–116.Melby S.J., Gaynor S.L., Lubahn J.G. et al. Efficacy and safety of right and left atrial ablations on the beating heart with irrigated bipolar radiofrequency energy: a long-term animal study // J. Thorac. Cardiovasc. Surg. – 2006. – Vol. 132. – P. 853–860.Melby S.J., Gaynor S.L., Lubahn J.G. et al. Efficacy and safety of right and left atrial ablations on the beating heart with irrigated bipolar radiofrequency energy: a long-term animal study // J. Thorac. Cardiovasc. Surg. – 2006. – Vol. 132. – P. 853–860.Prasad S.M., Maniar H.S., Schuessler R.B. et al. Chronic transmural atrial ablation by using bipolar radiofrequency energy on the beating heart // J. Thorac. Cardiovasc. Surg. – 2002. – Vol. 124. – P. 708–713.Prasad S.M., Maniar H.S., Schuessler R.B. et al. Chronic transmural atrial ablation by using bipolar radiofrequency energy on the beating heart // J. Thorac. Cardiovasc. Surg. – 2002. – Vol. 124. – P. 708–713.

The authors declare that there are no conflicts of interest present.