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Blagova OV, Nedostup AV, Kogan EA, et al. Myocardial Biopsy In "Idiopathic» Atrial Fibrillation And Other Arrhythmias: Nosological Diagnosis, Clinical And Morphological Parallels, And Treatment. J Atr Fibrillation. 2016;9(1):1414doi: 10.4022/jafib.1414.
Blagova, O. V., Nedostup, A. V., Kogan, E. A., Sulimov, V. A., Abugov, S. A., Kupriyanova, A. G., Zaydenov, V. A., Donnikov, A. E., Zaklyazminskaya, E. V., & Okisheva, E. A. (2016). Myocardial Biopsy In "Idiopathic» Atrial Fibrillation And Other Arrhythmias: Nosological Diagnosis, Clinical And Morphological Parallels, And Treatment. Journal of atrial fibrillation, 9(1), 1414. https://doi.org/10.4022/jafib.1414
Blagova, O V, et al. "Myocardial Biopsy In "Idiopathic» Atrial Fibrillation And Other Arrhythmias: Nosological Diagnosis, Clinical And Morphological Parallels, And Treatment." Journal of atrial fibrillation vol. 9,1 (2016): 1414. doi: https://doi.org/10.4022/jafib.1414
Blagova OV, Nedostup AV, Kogan EA, Sulimov VA, Abugov SA, Kupriyanova AG, Zaydenov VA, Donnikov AE, Zaklyazminskaya EV, Okisheva EA. Myocardial Biopsy In "Idiopathic» Atrial Fibrillation And Other Arrhythmias: Nosological Diagnosis, Clinical And Morphological Parallels, And Treatment. J Atr Fibrillation. 2016 Jun 30;9(1):1414. doi: 10.4022/jafib.1414. eCollection 2016. PMID: 27909515; PMCID: PMC5089509.
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J Atr Fibrillation. 2016 Jun 30;9(1):1414. doi: 10.4022/jafib.1414. eCollection 2016.

Myocardial Biopsy In "Idiopathic» Atrial Fibrillation And Other Arrhythmias: Nosological Diagnosis, Clinical And Morphological Parallels, And Treatment.

Journal of atrial fibrillation

O V Blagova, A V Nedostup, E A Kogan, V A Sulimov, S A Abugov, A G Kupriyanova, V A Zaydenov, A E Donnikov, E V Zaklyazminskaya, E A Okisheva

Affiliations

  1. Sechenov First Moscow State Medical University 119992, Moscow, B.Pirogovskaya str., 6.
  2. Petrovsky Russian Scientific Center of Surgery. RAMS.
  3. humakov Scientific Center of Transplantation and Artificial Organs.
  4. Kulakov Scientific Center for Obstetrics, Gynecology and Perinatology.

PMID: 27909515 PMCID: PMC5089509 DOI: 10.4022/jafib.1414

Abstract

BACKGROUND: The nosological nature of "idiopathic" arrhythmias and the effect of etiotropic and pathogenetic treatment are often unknown.

METHODS AND RESULTS: 19 patients (42.6±11.3 years, 9 women) with atrial fibrillation (n = 16), supraventricular (n = 10) and ventricular (n = 4) premature beats, supraventricular (n = 2) and ventricular tachycardia (n = 1), left bundle branch block (n= 2), AV block (n = 2) without structural heart changes. Viruses were identified (polymerase chain reaction, PCR) along with measurement of anti-heart antibodies (AHA) and endomyocardial biopsy (EMB). EMB allowed to establish diagnosis in all patients: infectious-immune myocarditis (n = 11, parvovirus-positive in 1),parvovirus-positive endomyocarditis (n = 1),systemic (n = 2) and myocardial (n = 1) vasculitis,Fabry's disease (n = 1), arrhythmogenic right ventricular dysplasia (n = 1),unspecified genetic cardiomyopathy (n = 2, herpes virus 6 one positive). Level of AHA had the greatest significance for myocarditis diagnostics. All patients with myocarditis/vasculitis had background therapy: acyclovir (n = 10), IV immunoglobulin (n = 2), meloxicam (n = 12), hydroxychloroquine (n = 15), steroids (n = 14, 31.1±12.5 mg/day), azathioprine 150 mg/day (n = 2). Median follow-up was 4 years. Treatment significantly reduced the rate of arrhythmias (8 [5;8] to 3 [1.25;7.75] points); disappearance of bundle branch block was noted.

CONCLUSION: EMB allowed to diagnose immune-mediated inflammatory diseases in 78.9% patients with 'idiopathic' arrhythmias and genetic diseases in 21.1%. Background therapy of myocarditis improved the antiarrhythmic efficiency, and allowed the best premed for interventional treatment.

Keywords: Endomyocardial Biopsy; Idiopathic Arrhythmias; Immunosuppressive Therapy; Lone Atrial Fibrillation; Myocardial Vasculitis; Myocarditis

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