vestarВестник аритмологииJournal of Arrhythmology1561-86412658-7327НАО «Инкарт»10.35336/VA-1641XUWXQGvestar-1665Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLEЭффективность и безопасность лаппаконитина гидробромида пролонгированного при предсердной экстрасистолии: пилотное наблюдательное исследованиеEfficacy and safety of prolonged-release lappaconitine hydrobromide in premature atrial contractions: pilot observational studyhttps://orcid.org/0000-0002-8736-1575ШубикЮ. В.ShubikYu. V.

Санкт-Петербург, пр. Луначарского, д. 40, к. 4 

Shubik Yuriy

Saint Petersburg, 40/4 Lunacharskogo ave 

https://orcid.org/0000-0003-1510-9204КанорскийС. Г.KanorskiyS. G.

 Краснодар, ул. Митрофана Седина, д. 4 

Krasnodar, 4 Mitrofana Sedina str. 

https://orcid.org/0000-0002-6086-6784БерманМ. В.BermanM. V.

Санкт-Петербург, пр. Луначарского, д. 40, к. 4 

Saint Petersburg, 40/4 Lunacharskogo ave 

https://orcid.org/0000-0002-6796-8302ПолищукЛ. В.PolishchukL. V.

 Краснодар, ул. Митрофана Седина, д. 4 

Krasnodar, 4 Mitrofana Sedina str. 

https://orcid.org/0000-0001-5940-6492РивинА. Е.RivinA. E.

Санкт-Петербург, пр. Луначарского, д. 40, к. 4 

Saint Petersburg, 40/4 Lunacharskogo ave 

ООО «Северо-западный центр диагностики и лечения аритмий»РоссияNorth-West Center for Diagnosis and Treatment of ArrhythmiasRussian FederationФГБОУ ВО «Кубанский государственный медицинский университет» МЗ РФРоссияKuban State Medical UniversityRussian Federation2026130620263326574Copyright © Шубик Ю.В., Канорский С.Г., Берман М.В., Полищук Л.В., Ривин А.Е., 20262026Шубик Ю.В., Канорский С.Г., Берман М.В., Полищук Л.В., Ривин А.Е.Shubik Y.V., Kanorskiy S.G., Berman M.V., Polishchuk L.V., Rivin A.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestar.elpub.ru/jour/article/view/1665Цель

Цель. Оценить эффективность и безопасность пролонгированной формы лаппаконитина гидробромида в минимальной дозе 25 мг дважды в сутки при предсердной экстрасистолии (ПЭС) у пациентов без структурных изменений сердца.

Материал и методы исследования. В ретроспективное открытое нерандомизированное наблюдательное исследование были включены 52 пациента (20 мужчин) в возрасте 31-79 лет с симптомной ПЭС и/или пароксизмальной фибрилляцией предсердий, требующими антиаритмической терапии. Всем пациентам проводилось два холтеровских мониторирования электрокардиограммы: до назначения терапии и через 2-3 недели на фоне приема лаппаконитина гидробромида пролонгированного в дозе 25 мг дважды в сутки. Все количественные показатели предсердной эктопической активности были нормированы на 24 часа. Эффективность оценивалась по изменению числа одиночных, парных и групповых ПЭС, эпизодов пароксизмальной фокусной предсердной тахикардии, индекса экстрасистолической нагрузки, а также по распределению респондеров. Безопасность анализировалась по динамике частоты сердечных сокращений, длительности зубца P, интервалов PQ, комплекса QRS, QT и QTc. Анализ отдельных форм предсердной эктопической активности проводился только у пациентов, у которых соответствующие виды аритмий регистрировались при исходном исследовании и имелись полные данные для оценки их динамики на фоне терапии.

Результаты

Результаты. На фоне терапии отмечено статистически значимое снижение частоты всех форм предсердной эктопической активности: одиночной ПЭС, парной ПЭС, групповой ПЭС и пароксизмальной фокусной предсердной тахикардии (во всех случаях p<0,001). У большинства пациентов снижение частоты аритмии составило ≥75%. Аналогичный эффект сохранялся в подгруппе больных с высоким исходным «бременем» ПЭС (>500 в сутки). Частота сердечных сокращений умеренно снижалась; отмечено статистически значимое, но клинически несущественное увеличение интервала PQ. Существенных изменений длительности зубца P, комплекса QRS, а также интервалов QT и QTc не выявлено.

Заключение

Заключение. Пролонгированная форма лаппаконитина гидробромида в минимальной дозе 50 мг в сутки обеспечивает статистически значимое снижение предсердной эктопической активности у пациентов без структурных изменений сердца и характеризуется благоприятным профилем безопасности при двукратном режиме приема.

Aim

Aim. To evaluate the efficacy and safety of the prolonged-release formulation of lappaconitine hydrobromide at the minimum dose of 25 mg twice daily in patients with premature atrial contractions (PACs) and no structural heart disease. 

Methods

Methods. This retrospective open-label non-randomized observational study included 52 patients (20 men) aged 31-79 years with symptomatic PACs and/or paroxysmal atrial fibrillation requiring antiarrhythmic therapy. All patients underwent two Holter ECG recordings: before treatment initiation and after 2-3 weeks of therapy with prolonged-release lappaconitine hydrobromide 25 mg twice daily. All quantitative indices of atrial ectopic activity were normalized to 24 hours. Efficacy was assessed by changes in the number of single, paired, and grouped PACs, episodes of paroxysmal focal atrial tachycardia (AT), the ectopic burden index, and the distribution of responders. Safety was assessed by changes in heart rate, P-wave, QRS complex, PQ, QT and QTc intervals duration. Analysis of individual forms of atrial ectopic activity was performed only in patients in whom the corresponding types of arrhythmia were present at baseline and for whom complete data were available to assess their changes during therapy.

Results

Results. Therapy was associated with a statistically significant reduction in all forms of atrial ectopic activity, including single PACs, paired PACs, grouped PACs, and episodes of paroxysmal focal AT (all p<0.001). In most patients, the reduction in arrhythmia frequency was ≥75%. A similar effect was observed in the subgroup with a high baseline PAC burden (>500 PACs per 24 hours). Heart rate decreased moderately; a statistically significant but clinically insignificant increase in the PQ interval was observed. No significant changes were found in P-wave duration, QRS duration, or QT and QTc intervals.

Conclusion

Conclusion. The prolonged-release formulation of lappaconitine hydrobromide at the minimum daily dose of 50 mg provides a statistically significant reduction in atrial ectopic activity in patients without structural heart disease and is characterized by a favorable safety profile when administered twice daily.

предсердная экстрасистолияодиночная экстрасистолияпарная экстрасистолиягрупповая экстрасистолияпароксизмальная предсердная тахикардиялаппаконитина гидробромид пролонгированныйхолтеровское мониторирование ЭКГэффективностьбезопасностьpremature atrial contractions (beats)single premature atrial contractionspaired premature atrial contractionsgrouped premature atrial contractionsparoxysmal atrial tachycardiaprolonged-release lappaconitine hydrobromideHolter ECG monitoringefficacysafetyReferencesБокерия ЛА, Голухова ЕЗ, Попов СВ, и др. Наджелудочковые тахикардии у взрослых. Клинические рекомендации 2020. Российский кардиологический журнал. 2021;26(5): 4484. https://doi.org/10.15829/1560-4071-2021-4484.Bokeria LA, Golukhova EZ, Popov SV, et al. 2020 Clinical practice guidelines for supraventricular tachycardia in adults. Russian Journal of Cardiology. 2021;26(5): 4484. (In Russ.). https://doi.org/10.15829/1560-4071-2021-4484.Попов СВ, Давтян КВ, Шубик ЮВ, и др. Наджелудочковые тахикардии. Клинические рекомендации 2025. Российский кардиологический журнал. 2025;30(7): 6448. https://doi.org/10.15829/1560-4071-2025-6448.Popov SV, Davtyan KV, Shubik YuV, et al. Supraventricular tachycardias. Clinical guidelines 2025. Russian Journal of Cardiology. 2025;30(7): 6448. (In Russ.). https://doi.org/10.15829/1560-4071-2025-6448.Шубик ЮВ, Тихоненко ВМ. Холтеровское мониторирование при аритмиях. В 2-х томах. Санкт-Петербург; 2019.Shubik YuV, Tikhonenko VM. Holter monitoring in arrhythmias. In 2 volumes. Saint Petersburg; 2019 (In Russ.).Тихоненко ВМ, Тулинцева ТЭ, Лышова ОВ, и др. Нарушения ритма и проводимости сердца у здоровых лиц. Вестник аритмологии. 2018;91: 11-20.Tikhonenko VM, Tulintseva TE, Lyshova OV, et al. Heart rhythm and conduction disorders in healthy individuals. Journal of Arrhythmology. 2018;91: 11-20 (In Russ.).Lin CY, Chang SL, Lin YJ, et al. Prognostic significance of premature atrial complexes burden in prediction of longterm outcome. J Am Heart Assoc. 2015;4(9): e002192. https://doi.org/10.1161/JAHA.115.002192.Lin CY, Chang SL, Lin YJ, et al. Prognostic significance of premature atrial complexes burden in prediction of longterm outcome. J Am Heart Assoc. 2015;4(9): e002192. https://doi.org/10.1161/JAHA.115.002192.Hsu NW, Tsao HM, Chen HC, et al. Different impacts of atrial fibrillation and cardiac premature contractions on the health-related quality of life in elderly people: the Yilan study. Tohoku J Exp Med. 2016;238(1): 75-83. https://doi.org/10.1620/tjem.238.75.Hsu NW, Tsao HM, Chen HC, et al. Different impacts of atrial fibrillation and cardiac premature contractions on the health-related quality of life in elderly people: the Yilan study. Tohoku J Exp Med. 2016;238(1): 75-83. https://doi.org/10.1620/tjem.238.75.He B, Li Y, Huang W, et al. Mapping and ablation of isolated frequent symptomatic premature atrial contractions in patients with structurally normal heart. Front Cardiovasc Med. 2022;9: 862659. https://doi.org/10.3389/fcvm.2022.862659.He B, Li Y, Huang W, et al. Mapping and ablation of isolated frequent symptomatic premature atrial contractions in patients with structurally normal heart. Front Cardiovasc Med. 2022;9: 862659. https://doi.org/10.3389/fcvm.2022.862659.Riesinger L, Siebermair J, Wakili R. Mapping strategies and ablation of premature atrial complexes. Herzschrittmacherther Elektrophysiol. 2021;32(1): 9-13. https://doi.org/10.1007/s00399-021-00744-9.Riesinger L, Siebermair J, Wakili R. Mapping strategies and ablation of premature atrial complexes. Herzschrittmacherther Elektrophysiol. 2021;32(1): 9-13. https://doi.org/10.1007/s00399-021-00744-9.Haïssaguerre M, Jaïs P, Shah DC, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med. 1998;339(10): 659- 666. https://doi.org/10.1056/NEJM199809033391003.Haïssaguerre M, Jaïs P, Shah DC, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med. 1998;339(10): 659- 666. https://doi.org/10.1056/NEJM199809033391003.Prasitlumkum N, Rattanawong P, Limpruttidham N, et al. Frequent premature atrial complexes as a predictor of atrial fibrillation: systematic review and meta-analysis. J Electrocardiol. 2018;51(5): 760-767. https://doi.org/10.1016/j.jelectrocard.2018.07.004.Prasitlumkum N, Rattanawong P, Limpruttidham N, et al. Frequent premature atrial complexes as a predictor of atrial fibrillation: systematic review and meta-analysis. J Electrocardiol. 2018;51(5): 760-767. https://doi.org/10.1016/j.jelectrocard.2018.07.004.Guichard JB, Guasch E, Roche F, et al. Premature atrial contractions: a predictor of atrial fibrillation and a relevant marker of atrial cardiomyopathy. Front Physiol. 2022;13: 971691. https://doi.org/10.3389/fphys.2022.971691.Guichard JB, Guasch E, Roche F, et al. Premature atrial contractions: a predictor of atrial fibrillation and a relevant marker of atrial cardiomyopathy. Front Physiol. 2022;13: 971691. https://doi.org/10.3389/fphys.2022.971691.Sasaki N, Yamamoto T, Sugiyama K, et al. High burden of premature atrial contractions predicts atrial fibrillation. Circ J. 2021;85(8): 1343-1348. https://doi.org/10.1253/circj.CJ-20-1277.Sasaki N, Yamamoto T, Sugiyama K, et al. High burden of premature atrial contractions predicts atrial fibrillation. Circ J. 2021;85(8): 1343-1348. https://doi.org/10.1253/circj.CJ-20-1277.Larsen BS, Kumarathurai P, Falkenberg J, Nielsen OW, Sajadieh A. Excessive atrial ectopy and short atrial runs increase the risk of stroke beyond incident atrial fibrillation. J Am Coll Cardiol. 2015;66(3): 232-241. https://doi.org/10.1016/j.jacc.2015.05.018.Larsen BS, Kumarathurai P, Falkenberg J, Nielsen OW, Sajadieh A. Excessive atrial ectopy and short atrial runs increase the risk of stroke beyond incident atrial fibrillation. J Am Coll Cardiol. 2015;66(3): 232-241. https://doi.org/10.1016/j.jacc.2015.05.018.Acharya T, Tringali S, Bhullar M, et al. Frequent atrial premature complexes and their association with risk of atrial fibrillation. Am J Cardiol. 2015;116(12): 1852-1857. https://doi.org/10.1016/j.amjcard.2015.09.025.Acharya T, Tringali S, Bhullar M, et al. Frequent atrial premature complexes and their association with risk of atrial fibrillation. Am J Cardiol. 2015;116(12): 1852-1857. https://doi.org/10.1016/j.amjcard.2015.09.025.Hindricks G, Potpara T, Dagres N, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2021;42(5): 373-498. https://doi.org/10.1093/eurheartj/ehaa612.Hindricks G, Potpara T, Dagres N, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2021;42(5): 373-498. https://doi.org/10.1093/eurheartj/ehaa612.Van Gelder IC, Rienstra M, Bunting KV, et al. 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2024;45(36): 3314-3414. https://doi.org/10.1093/eurheartj/ehae176.Van Gelder IC, Rienstra M, Bunting KV, et al. 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2024;45(36): 3314-3414. https://doi.org/10.1093/eurheartj/ehae176.Calkins H, Hindricks G, Cappato R, et al. 2017 HRS/ EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. Europace. 2018;20(1): e1-e160. https://doi.org/10.1093/europace/eux274.Calkins H, Hindricks G, Cappato R, et al. 2017 HRS/ EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. Europace. 2018;20(1): e1-e160. https://doi.org/10.1093/europace/eux274.January CT, Wann LS, Calkins H, et al. 2019 AHA/ ACC/HRS focused update of the 2014 guideline for the management of patients with atrial fibrillation. Circulation. 2019;140(2): e125-e151. https://doi.org/10.1161/CIR.0000000000000665.January CT, Wann LS, Calkins H, et al. 2019 AHA/ ACC/HRS focused update of the 2014 guideline for the management of patients with atrial fibrillation. Circulation. 2019;140(2): e125-e151. https://doi.org/10.1161/CIR.0000000000000665.Hillmann HAK, Soltani S, Mueller-Leisse J, et al. Cardiac rhythm monitoring using wearables for clinical guidance before and after catheter ablation. J Clin Med. 2022;11(9): 2428. https://doi.org/10.3390/jcm11092428.Hillmann HAK, Soltani S, Mueller-Leisse J, et al. Cardiac rhythm monitoring using wearables for clinical guidance before and after catheter ablation. J Clin Med. 2022;11(9): 2428. https://doi.org/10.3390/jcm11092428.Palmisano P, Accogli M, Zaccaria M, et al. Expert opinion on continuous rhythm monitoring of patients with atrial fibrillation for candidates or patients who have already undergone ablation. Int J Cardiol. 2020;304: 49-55. https://doi.org/10.1016/j.ijcard.2020.02.001.Palmisano P, Accogli M, Zaccaria M, et al. Expert opinion on continuous rhythm monitoring of patients with atrial fibrillation for candidates or patients who have already undergone ablation. Int J Cardiol. 2020;304: 49-55. https://doi.org/10.1016/j.ijcard.2020.02.001.Unni RR, Prager RT, Odabashian R, et al. Rhythm-monitoring strategy and arrhythmia recurrence in atrial fibrillation ablation trials: a systematic review and meta-regression analysis. CJC Open. 2022;4(5): 449-465. https://doi.org/10.1016/j.cjco.2022.02.001.Unni RR, Prager RT, Odabashian R, et al. Rhythm-monitoring strategy and arrhythmia recurrence in atrial fibrillation ablation trials: a systematic review and meta-regression analysis. CJC Open. 2022;4(5): 449-465. https://doi.org/10.1016/j.cjco.2022.02.001.Damiano RJ Jr, Badhwar V, Acker MA, et al. Detection of atrial fibrillation after surgical ablation: conventional versus continuous monitoring. Ann Thorac Surg. 2016;101(1): 42-47. https://doi.org/10.1016/j.athoracsur. 2015.07.039.Damiano RJ Jr, Badhwar V, Acker MA, et al. Detection of atrial fibrillation after surgical ablation: conventional versus continuous monitoring. Ann Thorac Surg. 2016;101(1): 42-47. https://doi.org/10.1016/j.athoracsur. 2015.07.039.Aguilar M, Xue X, Alqarawi W, et al. Influence of monitoring strategy on assessment of ablation success and postablation atrial fibrillation burden. Circulation. 2022;145(1): 21-30. https://doi.org/10.1161/CIRCULATIONAHA.121.056071.Aguilar M, Xue X, Alqarawi W, et al. Influence of monitoring strategy on assessment of ablation success and postablation atrial fibrillation burden. Circulation. 2022;145(1): 21-30. https://doi.org/10.1161/CIRCULATIONAHA.121.056071.Schwab AC, Abugattas AN, Frontera A, et al. Rhythm monitoring, success definition, recurrence, and anticoagulation after atrial fibrillation ablation: results of an EHRA survey. Europace. 2023;25(2): euac194. https://doi.org/10.1093/europace/euac194.Schwab AC, Abugattas AN, Frontera A, et al. Rhythm monitoring, success definition, recurrence, and anticoagulation after atrial fibrillation ablation: results of an EHRA survey. Europace. 2023;25(2): euac194. https://doi.org/10.1093/europace/euac194.Verma A, Champagne J, Sapp J, et al. Discerning the incidence of symptomatic and asymptomatic episodes of atrial fibrillation before and after catheter ablation (DISCERN AF): a prospective, multicenter study. JAMA Intern Med. 2013;173(2): 149-156. https://doi.org/10.1001/jamainternmed.2013.1561.Verma A, Champagne J, Sapp J, et al. Discerning the incidence of symptomatic and asymptomatic episodes of atrial fibrillation before and after catheter ablation (DISCERN AF): a prospective, multicenter study. JAMA Intern Med. 2013;173(2): 149-156. https://doi.org/10.1001/jamainternmed.2013.1561.Simantirakis EN, Papakonstantinou PE, Chlouverakis GI, et al. Asymptomatic versus symptomatic episodes in patients with paroxysmal atrial fibrillation via long-term monitoring with implantable loop recorders. Int J Cardiol. 2017;231: 125-130. https://doi.org/10.1016/j.ijcard.2016.12.025.Simantirakis EN, Papakonstantinou PE, Chlouverakis GI, et al. Asymptomatic versus symptomatic episodes in patients with paroxysmal atrial fibrillation via long-term monitoring with implantable loop recorders. Int J Cardiol. 2017;231: 125-130. https://doi.org/10.1016/j.ijcard.2016.12.025.Hermans ANL, Gawalko M, Dohmen L, et al. Longterm intermittent versus short continuous heart rhythm monitoring for atrial fibrillation recurrence after ablation. Int J Cardiol. 2021;329: 105-112. https://doi.org/10.1016/j.ijcard.2020.12.022.Hermans ANL, Gawalko M, Dohmen L, et al. Longterm intermittent versus short continuous heart rhythm monitoring for atrial fibrillation recurrence after ablation. Int J Cardiol. 2021;329: 105-112. https://doi.org/10.1016/j.ijcard.2020.12.022.Hermans ANL, Gawalko M, Dohmen L, et al. Mobile health solutions for atrial fibrillation detection and management: a systematic review. Clin Res Cardiol. 2022;111(5): 479-494. https://doi.org/10.1007/s00392-021-01941-9.Hermans ANL, Gawalko M, Dohmen L, et al. Mobile health solutions for atrial fibrillation detection and management: a systematic review. Clin Res Cardiol. 2022;111(5): 479-494. https://doi.org/10.1007/s00392-021-01941-9.Dan GA, Martinez-Rubio A, Agewall S, et al. Antiarrhythmic drugs-clinical use and clinical decision making: a consensus document from the European Heart Rhythm Association and European Society of Cardiology Working Group on Cardiovascular Pharmacology. Europace. 2018;20(5): 731-732an. https://doi.org/10.1093/europace/eux373.Dan GA, Martinez-Rubio A, Agewall S, et al. Antiarrhythmic drugs-clinical use and clinical decision making: a consensus document from the European Heart Rhythm Association and European Society of Cardiology Working Group on Cardiovascular Pharmacology. Europace. 2018;20(5): 731-732an. https://doi.org/10.1093/europace/eux373.Vaughan Williams EM. A classification of antiarrhythmic actions reassessed after a decade of new drugs. J Clin Pharmacol. 1984;24(4): 129-147. https://doi.org/10.1002/j.1552-4604.1984.tb01822.x.Vaughan Williams EM. A classification of antiarrhythmic actions reassessed after a decade of new drugs. J Clin Pharmacol. 1984;24(4): 129-147. https://doi.org/10.1002/j.1552-4604.1984.tb01822.x.Farinha JM, Lopes LR, Providência R, et al. Frequent premature atrial contractions as a signalling marker of atrial cardiomyopathy, incident atrial fibrillation, and stroke. Cardiovasc Res. 2023;119(2): 429-440. https://doi.org/10.1093/cvr/cvac054.Farinha JM, Lopes LR, Providência R, et al. Frequent premature atrial contractions as a signalling marker of atrial cardiomyopathy, incident atrial fibrillation, and stroke. Cardiovasc Res. 2023;119(2): 429-440. https://doi.org/10.1093/cvr/cvac054.Meng L, Li X, Li J, et al. Premature atrial contractions and the risk of incident atrial fibrillation: a systematic review and meta-analysis. Front Cardiovasc Med. 2022;9: 971691. https://doi.org/10.3389/fcvm.2022.971691.Meng L, Li X, Li J, et al. Premature atrial contractions and the risk of incident atrial fibrillation: a systematic review and meta-analysis. Front Cardiovasc Med. 2022;9: 971691. https://doi.org/10.3389/fcvm.2022.971691.Porterfield JG, Porterfield LM. Therapeutic efficacy and safety of oral propafenone for atrial fibrillation. Am J Cardiol. 1989;63(1): 114-116. https://doi.org/10.1016/0002-9149(89)91091-6.Porterfield JG, Porterfield LM. Therapeutic efficacy and safety of oral propafenone for atrial fibrillation. Am J Cardiol. 1989;63(1): 114-116. https://doi.org/10.1016/0002-9149(89)91091-6.Pritchett ELC, McCarthy EA, Wilkinson WE. Propafenone treatment of symptomatic paroxysmal supraventricular arrhythmias. A randomized, placebo-controlled, crossover trial in patients tolerating oral therapy. Ann Intern Med. 1991;114(7): 539-544. https://doi.org/10.7326/0003-4819-114-7-539.Pritchett ELC, McCarthy EA, Wilkinson WE. Propafenone treatment of symptomatic paroxysmal supraventricular arrhythmias. A randomized, placebo-controlled, crossover trial in patients tolerating oral therapy. Ann Intern Med. 1991;114(7): 539-544. https://doi.org/10.7326/0003-4819-114-7-539.Meinertz T, Lip GYH, Lombardi F, et al. Efficacy and safety of propafenone sustained release in the prophylaxis of symptomatic paroxysmal atrial fibrillation (ERAFT study). Am J Cardiol. 2002;90(12): 1300-1306. https://doi.org/10.1016/S0002-9149(02)02867-9.Meinertz T, Lip GYH, Lombardi F, et al. Efficacy and safety of propafenone sustained release in the prophylaxis of symptomatic paroxysmal atrial fibrillation (ERAFT study). Am J Cardiol. 2002;90(12): 1300-1306. https://doi.org/10.1016/S0002-9149(02)02867-9.Alboni P, Botto GL, Baldi N, et al. Outpatient treatment of recent-onset atrial fibrillation with the “pill-inthe-pocket” approach. N Engl J Med. 2004;351(23): 2384-2391. https://doi.org/10.1056/NEJMoa041233.Alboni P, Botto GL, Baldi N, et al. Outpatient treatment of recent-onset atrial fibrillation with the “pill-inthe-pocket” approach. N Engl J Med. 2004;351(23): 2384-2391. https://doi.org/10.1056/NEJMoa041233.Kishore AG, Leier CV, Magorien RD. Guidelines for the use of propafenone in treating supraventricular arrhythmias. Clin Cardiol. 1995;18(10): 591-596.Kishore AG, Leier CV, Magorien RD. Guidelines for the use of propafenone in treating supraventricular arrhythmias. Clin Cardiol. 1995;18(10): 591-596.Alboni P, Botto GL, Boriani G, et al. Intravenous administration of flecainide or propafenone in patients with recent-onset atrial fibrillation does not predict adverse effects during “pill-in-the-pocket” treatment. Heart. 2010;96(7): 546-549. https://doi.org/10.1136/hrt.2009.187963.Alboni P, Botto GL, Boriani G, et al. Intravenous administration of flecainide or propafenone in patients with recent-onset atrial fibrillation does not predict adverse effects during “pill-in-the-pocket” treatment. Heart. 2010;96(7): 546-549. https://doi.org/10.1136/hrt.2009.187963.Aliot E, Capucci A, Crijns HJ, Goette A, Tamargo J. Twenty-five years in the making: flecainide is safe and effective for the management of atrial fibrillation. Europace. 2011;13(2): 161-173. https://doi.org/10.1093/europace/euq382.Aliot E, Capucci A, Crijns HJ, Goette A, Tamargo J. Twenty-five years in the making: flecainide is safe and effective for the management of atrial fibrillation. Europace. 2011;13(2): 161-173. https://doi.org/10.1093/europace/euq382.Echt DS, Ruskin JN. Use of flecainide for supraventricular arrhythmias. Am J Cardiol. 1990;65(18): 33B-39B.Echt DS, Ruskin JN. Use of flecainide for supraventricular arrhythmias. Am J Cardiol. 1990;65(18): 33B-39B.Khan IA. Oral loading single dose flecainide for pharmacological cardioversion of recent-onset atrial fibrillation. Int J Cardiol. 2003;87(2-3): 121-128. https://doi.org/10.1016/S0167-5273(02)00467-9.Khan IA. Oral loading single dose flecainide for pharmacological cardioversion of recent-onset atrial fibrillation. Int J Cardiol. 2003;87(2-3): 121-128. https://doi.org/10.1016/S0167-5273(02)00467-9.Capucci A, Villani GQ, Aschieri D, et al. Safety of oral flecainide for the conversion of recent-onset atrial fibrillation in out-of-hospital practice. Am J Cardiol. 1992;70(1): 69-72.Capucci A, Villani GQ, Aschieri D, et al. Safety of oral flecainide for the conversion of recent-onset atrial fibrillation in out-of-hospital practice. Am J Cardiol. 1992;70(1): 69-72.Кондори Леандро ЭИ, Лебедев ДС, Михайлов ЕН. Терапевтические возможности флекаинида при нарушениях ритма сердца: краткий обзор исследований и клинических рекомендаций. Вестник аритмологии. 2024;31(3): e1-e7. https://doi.org/10.35336/VA-1397.Condori Leandro EI, Lebedev DS, Mikhaylov EN. Therapeutic potential of flecainide for cardiac arrhythmias: a short review of studies and clinical recommendations. Journal of Arrhythmology. 2024;31(3): e1-e7 (In Russ.). https://doi.org/10.35336/VA-1397.Коркушко ОВ, Шатило ВБ, Мороз ГЗ, Шатило ТВ. Антиаритмическая эффективность и гемодинамический эффект этацизина у пациентов среднего и пожилого возраста с ИБС и экстрасистолией. Клиническая медицина. 1989;67(3): 74-78.Korkushko OV, Shatilo VB, Moroz GZ, Shatilo TV. Antiarrhythmic efficacy and hemodynamic effect of ethacizine in middle-aged and elderly patients with ischemic heart disease and extrasystole. Klinicheskaya Meditsina. 1989;67(3): 74-78 (In Russ.)Царегородцев ДА, Окишева ЕА, Грачева ЕИ, и др. Новый подход к оценке эффективности и безопасности этацизина у пациентов без морфологической патологии сердца. Кардиология и сердечно-сосудистая хирургия. 2014;7(2): 89-96.Tsaregorodtsev DA, Okisheva EA, Gracheva EI, et al. The new approach to efficiency and safety evaluation of etacizin in patients without morphological heart pathology. Cardiology and Cardiovascular Surgery. 2014;7(2): 89-96 (In Russ.).Лозинский ЛГ, Калинин ВН, Ардашева НВ, и др. Результаты лечения пароксизмальной фибрилляции предсердий этацизином. Кардиология. 1989;29(8): 57- 61.Lozinskii LG, Kalinin VN, Ardasheva NV, et al. Results of the treatment of paroxysmal atrial fibrillation with ethacizine. Kardiologiia. 1989;29(8): 57-61 (In Russ.).Белялов ФИ, Буторин НН, Кузнецов ВА, и др. Антиаритмическая эффективность этацизина у пациентов с наджелудочковой экстрасистолией. Вестник аритмологии. 2005;40: 25-30.Belyalov FI, Butorin NN, Kuznetsov VA, et al. Antiarrhythmic efficacy of ethacizine in patients with supraventricular extrasystole. Journal of Arrhythmology. 2005;40: 25-30 (In Russ.).Арчакова ОА, Багаева НС, Комаров ТН, и др. Фармакокинетическое исследование пролонгированной формы лаппаконитина гидробромида (Аллафорте®). Разработка и регистрация лекарственных средств. 2022;11(1): 140-147. https://doi.org/10.33380/2305-2066-2022-11-1-140-147.Archakova OA, Bagaeva NS, Komarov TN, et al. Pharmacokinetics study of the long-acting form of lappaconitine hydrobromide (Allaforte®). Drug Development and Registration. 2022;11(1): 140-147. (In Russ.). https://doi.org/10.33380/2305-2066-2022-11-1-140-147.Ревишвили АШ, Голицын СП, Аксентьев СБ, и др. Сравнительное исследование пролонгированной формы лаппаконитина гидробромида (Аллафорте®) и пропафенона у пациентов с пароксизмальной фибрилляцией предсердий. Врач. 2024;35(1): 20-26. https://doi.org/10.29296/25877305-2024-01-04Revishvili ASh, Golitsyn SP, Aksentiev SB, et al. Comparative study of extended-release lappaconitine hydrobromide (Allaforte®) and propafenone in patients with paroxysmal atrial fibrillation. Vrach. 2024;35(1): 20-26. (In Russ.). https://doi.org/10.29296/25877305-2024-01-04Эрлих АД. Изучение доказательной базы применения лаппаконитина гидробромида у пациентов с фибрилляцией предсердий. Кардиология. 2016;56(3): 48- 53. https://doi.org/10.18565/cardio.2016.3.48-53.Erlikh AD. The study of evidence base for the use of lappaconitine hydrobromide in patients with atrial fibrillation. Kardiologiia. 2016;56(3): 48-53. (In Russ.). https://doi.org/10.18565/cardio.2016.3.48-53.Вахитова ЮВ, Фарафонтова ЕИ, Хисамутдинова РЮ, и др. К механизмам антиаритмического действия аллапинина. Биоорганическая химия. 2013;39(1): 105-116. doi:10.1134/S1068162013010111. https://doi.org/10.1134/S1068162013010111.Vakhitova YuV, Farafontova EI, Khisamutdinova RYu, et al. To the mechanisms of antiarrhythmic action of Allapinine. Bioorganicheskaya Khimiya. 2013;39(1): 105-116. (In Russ.). https://doi.org/10.1134/S1068162013010111.Канорский СГ, Шубик ЮВ. Антиаритмические препараты класса Ic в клинической практике: место лаппаконитина гидробромида. Врач. 2025;36(3): 32- 38. https://doi.org/10.29296/25877305-2025-03-06.Kanorskiy SG, Shubik YuV. Class Ic antiarrhythmic drugs in clinical practice: the role of lappaconitine hydrobromide. Vrach. 2025;36(3): 32-38. (In Russ.). https://doi.org/10.29296/25877305-2025-03-06.

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