Aim. To study the incidence and possible risk factors for atrial fibrillation (AF) in the early postoperative period after transapical implantation of the first domestic aortic valve (TAVI) “MedLab-CT”.

Material and methods. The study included 118 patients after successful TAVI. The study did not include patients with open aortic valve replacement due to dislocation of the prosthesis, with severe intraoperative complications leading to the death of the patient, and patients with permanent AF. The mean age of the patients was 71.1 ± 4.9 years, body mass index was 31.1 ± 5.9 kg/m2, men were 39.8%, hypertension was in 93.2%, diabetes mellitus (DM) was in 27.9%, paroxysmal AF was in 12.7%, coronary heart disease (CHD) was in 56.7%, smoking was noted in 8.4% cases. The median follow-up time corresponded to the hospital stay - 9.5 days. To identify cardiac arrhythmias, daily regular ECG recordings in 12 leads were assessed from the first day after TAVI. In the presence of palpitations, 24-hour ECG monitoring was performed. Indicators such as age, male gender, DM, history of AF, interatrial block before surgery, CHD, and echocardiographic parameters were studied as possible predictors of AF development in the early postoperative period after TAVI. There were no significant differences in the studied parameters in patients with AF paroxysms and sinus rhythm.

Results. In the early postoperative period, AF episodess occurred in 46 (39%) patients. New-onset AF occurred in 38 (32.2%) patients. The only statistically significant risk factor for AF in the postoperative period in our series of observations was CHD (OR 5.756; 95% CI 1.009-8.132; p = 0.048).

Conclusion. Patients with paroxysmal AF in the early postoperative period were not detected cerebrovascular events. In the early postoperative period, the only significant predictor of AF was the presence of proven CHD in patients.

To assess safety and efficacy of nonfluoroscopic cryoballoon ablation, 32 patients with symptomatic drug resistant paroxysmal atrial fibrillation were treated.

The factors that can potentially cause electromagnetic interference (EMI) of cardiac implantable electronic devices (CIED) during various methods of physiotherapy are considered. The mechanisms of CIED dysfunctions caused by EMI and safety measures for the use of physiotherapeutic treatment are discussed.

Differential diagnosis of ventricular and supraventricular wide QRS complexes arrhythmias remains one of the most urgent and serious problems of modern cardiology. High-precision intracardiac and transesophageal electrophysiological examination cannot be widely used in routine clinical practice because of the complexity of using, the risk of complications, and the necessary of special equipment. The availability and simplicity of electrocardiogram registration was the reason for study and development of ECG criteria and algorithms for differential diagnosis. However, their low accuracy, variety, complexity and laboriousness of application often leads to diagnostic errors and low usage of clinicians.

Because of the high prevalence of different types of arrhythmias in population, new strategies and treatment methods are being developed by medical communities. The most perspective strategy for treating refractory arrhythmias is stereotactic radioablation. This article presents the review of experimental and clinical researches of radioablation of different heart zones and describes the first experimental study of stereotactic heart radioablation in Russian Federation.

A case of post-puncture pneumothorax is presented, which complicated the pacemaker implantation, proceeding with an unclear clinical picture that was revealed solely due to a decrease in the voltage of the postoperative electrocardiogram.

Case of successful endocardial lead implantation into the His bundle position is presented. Technique and rare complication (transient atrioventricular block) are described.

A clinical observation of intramyocardial transvenous ethanol administration for the treatment of refractory ventricular extrasystole is presented. The procedure was carried out as part of a prospective international multicenter study “Intramural venous ethanol infusion for refractory ventricular arrhythmias”.

The results of examination and treatment of a patient with a combination of accelerated idioventricular rhythm and atrial conduction disorder, which made it difficult to interpret the Holter monitoring data, are presented.