HEMODYNAMIC BENEFITS OF RHYTHM CONTROL STRATEGY IN PATIENTS WITH PERSISTENT ATRIAL FIBRILLATION

Highlights

Since 2022 NICaS system developed by Israel company NiMedical was registered in Russia. It allows quick and reproducible assessment of hemodynamic indicators using bioimpedance cardiography. The evaluation of promising non-subjective (in comparison with Echo) method in patients with persistent atrial fibrillation is reported.

Aim. Compassion of hemodynamic indicators depending on rhythm or rate control strategy in patients with persistent atrial fibrillation.

Methods. The evaluation of hemodynamic changes in two comparable groups of patients with atrial fibrillation using bioimpedance cardiography and subsequent validation if the active restoration of sinus rhythm or rate control is reasonable as first line tactics.

Results. When bioimpedance cardiogram was registered immediately after cardioversion, no significant changes in hemodynamic indicators were observed. A month later there were clear positive changes manifested by an improvement in cardiac output from 5.45 ± 2.25 L/min to 6.39 ± 2.81 L/min, p = 0.05, cardiac index from 2.64 ± 0.99 to 3.09 ± 1.28, p = 0.029, cardiac power index from 0.57 ± 0.22 to 0.66 ± 0.26, p = 0.027, as well as total peripheral resistance index reduction from 3562.22 ± 1709.86 to 2900.86 ± 1139.16, p = 0.05. In the rate control group positive tendency was also noticed, but there was no statistical reliability.

Conclusion. A preliminary analysis of the hemodynamic parameters in patients with persistent atrial fibrillation using the impedance cardiography method allows us to conclude about the convenience of these measurements and serves as additional argument for rhythm control approach.

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