cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLCcardiovascular-1192Research ArticleРАЗНОЕИспользование ω-3 полиненасыщенных жирных кислот для профилактики фибрилляции предсердий после операции коронарного шунтированияOmega-3 polyunsaturated fatty acids in atrial fibrillation prevention after coronary bypass surgeryТатарскийБ. А.TatarskyB. A.btat@mail.ruНИИ кардиологии имени В.А.Алмазова Росздрава, Санкт-ПетербургV.A. Almazov Research Institute of Cardiology, Federal State Agency for Health and Social Development. St. Petersburg200720042007625258Copyright © Татарский Б.А., 20072007Татарский Б.А.Tatarsky B.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/1192

Цель. Изучить влияние омега-3 полиненасыщенных жирных кислот (w-3 ПНЖК) на предсердную аритмогенность пациентов с ишемической болезнью сердца, перенесших операцию коронарного шунтирования (КШ). Материал и методы. Обследованы 50 больных ИБС, перенесших операцию КШ. Все пациенты были разделены на две группы. I группу составили 25 больных c эпизодами фибрилляции предсердий (ФП) в анамнезе, которые принимали w-3 ПНЖК в дозе 2 г/сут. в течение недели до и 7 дней после КШ. В контрольную группу (II) вошли 25 больных без ФП в анамнезе и не принимавшие w-3 ПНЖК. Для определения нарушений предсердного проведения использовался неинвазивный метод чреспищеводной электрографии высокого разрешения. Результаты. У пациентов II группы в ранние сроки после КШ в 7 (28%) случаях регистрировали ФП. У пациентов, лечившихся w-3-ПНЖК, пароксизмы ФП зарегистрированы на 2-3 сутки у 4 пациентов (16%). Клиническая симптоматика была менее выраженной по сравнению с пациентами из контрольной группы. Ни в одном случае не потребовалось выполнение кардиоверсии, все пароксизмы спонтанно купировались. В группе пациентов, принимавших w-3-ПНЖК, отмечали ускорение проведения возбуждения по правому и левому предсердиям. Заключение. Назначение w-3-ПНЖК пациентам с риском возникновения ФП после КШ сопровождается снижением частоты развития аритмии, склонностью к самостоятельному купированию, меньшей выраженностью гемодинамических нарушений. Добавление w-3 ПНЖК к стандартной терапии пациентам после КШ эффективно и безопасно.

Aim. To assess omega-3-polyunsaturated fatty acids (w-3-PUFA) effects on atrial arrhythmogenicity in patients with coronary heart disease, who underwent coronary bypass surgery (CBS). Material and methods. In total, 50 patients, who underwent CBS, were examined. All participants were divided into two groups. Group I included 25 patients with atrial fibrillation (AF) episodes in anamnesis, who were administered w-3-PUFA (2 g/d) one week before and 7 days after CBS. Group II, control group, included 25 patients without AF in anamnesis, who did not receive w-3-PUFA. Atrial conduction abnormalities were registered by non-invasive, high-definition transesophageal electrocardiography. Results. In Group II, 7 AF cases (28%) were registered during early post-CBS period. AF paroxysm incidence was maximal in the first two days after CBS. In Group I, AF paroxysms were registered in 4 patients (16%), on Day 2-3 after CBS. Clinical symptoms were less severe in Group I than in Group II: in the former, two patients had asymptomatic AF episodes. No AF cases required cardioversion, terminating spontaneously. Group I patients demonstrated increased right and left atrium conductivity. Conclusion. In patients with post4CBS AF risk, w-3-PUFA therapy was associated with arrhythmia risk reduction, pontaneously terminating AF episodes, and less severe hemodynamic disturbances. Adding w-3-PUFA to standard therapy is effective and safe in CBS patients.

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