STUDYING THE FEATURES OF BETA-ADRENOREACTION IN PATIENTS BEFORE AND AFTER INTERVENTIONAL TREATMENT OF ATRIAL FIBRILLATION

BACKGROUND
It is known that the autonomic nervous system plays a significant role in the onset, maintenance and arrest of atrial fibrillation. Its influence is deter­mined by a combination of direct and indirect ef­fects on the special conductive cardiac tissue, myo­cardium, baroreceptors and cardiac vessels. An indi­rect indicator of the activity of the sympathoadrenal system is beta-adrenoreactivity of erythrocyte mem­branes (beta-ARM). It is determined by the distribu­tion density of в-adrenergic receptors on cell mem­branes and the degree of their affinity for plasma cat­echolamines.
THE AIM OF THE STUDY
To evaluate the level of beta-adrenoreactivi­ty of erythrocyte membranes before and after cath­eter treatment of atrial fibrillation and its influence on the effectiveness of this treatment.
MATERIALS AND METHODS
The study sample included 40 patients with vari­ous forms of atrial fibrillation: paroxysmal atrial fibril­lation was found in 25 (62.5 %) patients, persistent — in 10 (25.0 %), long-term persistent — in 5 (12.5 %). 13 (22.5 %) out of 40 patients were women. The me­dian age was 49 (44; 55) years. All patients underwent either interventional or radiofrequency or cryoballon ablation of atrial fibrillation. In order to study the level of beta-ARM, blood was taken from a peripheral vein
RESULTS
Cryoballon ablation was performed in 7 patients, radiofrequency ablation — in 33. The overall annu­al effectiveness of ablation (absence of atrial fibrilla­tion paroxysms) was 71.5 % for cryoballon ablation, 73.5 % — for radiofrequency ablation. Early relapses (up to 3 months after surgery) were more common after cryoballon ablation — in 28.5 % of cases versus 16.3 % after radiofrequency ablation. In the sample, myocar­ditis was diagnosed in 9 (22.5 %) patients. Beta-ARM value before surgery was 19.16 (12.46; 27.46), 3 days af­ter the surgery — 24.43 (15.38; 33.65), 3 months after the surgery — 20.27 (9.90; 27.71). The influence of beta­ARM levels at all control points on the overall effective­ness of the catheter procedure and on the development of early relapses of arrhythmia after ablation was assessed. The initial beta-ARM value differed in patients with ear­ly and late relapses of arrhythmia (14.28 (12.39; 22.55) and 24.68 (16.20; 39.26), respectively).
CONCLUSIONS
The study revealed the dynamics of changes in the level of beta-ARM with an increase in the indica­tor after surgery and its decrease almost to the initial lev­el 3 months after the surgery. However, it was not pos­sible to identify the influence of the level of erythrocyte membranes beta-ARM on the effectiveness of catheter treatment of atrial fibrillation in patients.