Effectiveness of Treating Patients with Stable Ischemic Heart Disease and Co-Existent Paroxysmal Atrial Fibrillation with Mebicar
AbstractAtrial fibrillation is a disturbance of heart rhythm, which is characterized by frequent contractions of atrial muscle fibers. Stable ischemic heart disease, arterial hypertension, heart failure, obesity are risk factors for progression of atrial fibrillation. Psycho-emotional stress, anxiety and depression can be the cause of atrial fibrillation paroxysm as well. The objective of the research was to study the effect of mebicаr in the treatment of paroxysmal atrial fibrillation considering anxiety-depressive symptoms. Materials and Methods. Observations were performed on patients with stable ischemic heart disease and co-existent paroxysmal atrial fibrillation using clinico-psychopathological research method (structured interview). The level of stress was determined on the L. Rider scale and the 10-Item perceived stress scale; the level of anxiety and depression was determined by means of the Hospital Anxiety and Depression Scale and the Patient Health Questionnaire-9. The evaluation of the free radical oxidation state was carried out using a spectrophotometric method to determine the activity of catalase, glutathione peroxidase, superoxide dismutase in the blood serum. Results. As a result of the analysis, it was found that the higher the level of anxiety-depressive disorders, the more frequent paroxysms of atrial fibrillation. High level of stress was found in 37.50% of men (p<0.01) and 31.25% of women (p<0.05) in Group 2b. The manifestations of the clinical level of anxiety and depression in men of Group 2b (p<0.05) were detected. Conclusions. The analysis of electrocardiogram indices showed the signs of atrial fibrillation (p<0.05), repolarization abnormalities (p<0.001), left ventricular hypertrophy (p<0.05), and the appearance of extrasystoles (p<0.001). Echocardiographic indices showed the signs of diffuse cardiosclerosis, severe left atrial dilatation (p<0.05) and reduced myocardial contractility, which was statistically confirmed. The use of anxiolytic medication – mebicar – during treatment helped significantly improve the clinical and hemodynamic parameters, which confirmed treatment effectiveness.
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