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

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.

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