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Оценка анатомии и функции левого предсердия по данным мультиспиральной компьютерной томографии при подготовке к радиочастотной катетерной абляции у пациентов с фибрилляцией предсердий

https://doi.org/10.24835/1607-0763-2017-5-39-55

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Аннотация

Фибрилляция предсердий (ФП) является наиболее распространенным нарушением ритма в  клинической практике. Оптимальной терапией ФП, рефрактерной к противоаритмическим  препаратам, на настоящий момент признана катетерная абляция (КА) аритмогенных очагов.  Визуализация перед проведением процедуры необходима для детальной оценки левого  предсердия, легочных вен и прилежащих анатомических структур, что позволяет  оптимально спланировать вмешательство, а также спрогнозировать и предотвратить возможные осложнения.

Цель исследования: определить роль мультиспиральной компьютерной томографии  (МСКТ) с контрастным усилением в обследовании пациентов с ФП, а также оценить  перспективы развития данной мето дики на основании систематического обзора мировой  литературы.

Материал и методы. Проанализированы 140 статей, находящихся в свободном доступе в  системе PubMed за период с 01.2009 по 01.2017 по запросам “MDCT left atrium”, “MDCT  pulmonary veins”, “MDCT atrial appendage”, а также ряд русскоязычных публикаций в системе eLibrary.

Результаты. В обзоре литературы представлены и систематизированы имеющиеся данные  по эпидемиологии и механизмам развития ФП, приведена актуальная классификация.  Рассмотрены преимущества МСКТ-диагностики перед другими методами визуализации как в  рамках подготовки к процедуре КА, так и последующего ведения пациентов.

Заключение. МСКТ является точным, эффективным и доступным методом, отвечающим  требованиям визуализации в рамках подготовки к КА. Кроме того, МСКТ в совокупности с  навигационной системой электроанатомического картирования увеличивает безопасность и  эффективность процедуры. В послеоперационном периоде МСКТ может быть использована  для диагностики осложнений и оценки результата.

Об авторах

В. И. Гурина
ФГБУ “Институт хирургии им. А.В. Вишневского” Минздрава России
Россия

аспирант отдела лучевой диагностики ФГБУ “Институт хирургии им. А.В. Вишневского” МЗ РФ, Москва

119997 Москва, ул. Большая Серпуховская, 27. Институт хирургии им. А.В. Вишневского. Тел.: 8-903-292-66-94



Е. В. Кондратьев
ФГБУ “Институт хирургии им. А.В. Вишневского” Минздрава России
Россия

канд. мед. наук, старший научный сотрудник отделения рентгенологии и магнитно-резонансных исследований ФГБУ “Институт хирургии им. А.В. Вишневского” МЗ РФ, Москва



А. Ш. Ревишвили
ФГБУ “Институт хирургии им. А.В. Вишневского” Минздрава России
Россия

академик РАН, профессор, доктор мед. наук, директор ФГБУ “Институт хирургии им. А.В. Вишневского” МЗ РФ, Москва



М. З. Алимурзаева
ФГБУ “Институт хирургии им. А.В. Вишневского” Минздрава России
Россия
аспирант отдела лучевой диагностики ФГБУ “Институт хирургии им. А.В. Вишневского” МЗ РФ, Москва


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Для цитирования:


Гурина В.И., Кондратьев Е.В., Ревишвили А.Ш., Алимурзаева М.З. Оценка анатомии и функции левого предсердия по данным мультиспиральной компьютерной томографии при подготовке к радиочастотной катетерной абляции у пациентов с фибрилляцией предсердий. Медицинская визуализация. 2017;(5):39-55. https://doi.org/10.24835/1607-0763-2017-5-39-55

For citation:


Gurina V.I., Kondrat’ev E.V., Revishvily A.S., Alimurzaeva M.Z. Evaluation of Left Atrial Anatomy and Function using Multidetector Computed Tomography in Patients Undergoing Catheter Ablation for Atrial Fibrillation. Medical Visualization. 2017;(5):39-55. (In Russ.) https://doi.org/10.24835/1607-0763-2017-5-39-55

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