I.A. POLYAKOV, I.G. TRUKHANOVA, D.S. ZINATULLINA

¹Samara State Medical University of the Ministry of Health of the Russian Federation, Samara

Polyakov I.A. ¾ post-graduate student of the Department of Anesthesiology, Resuscitation and Emergency Medical Aid

Address: 89 Chapaevskaya Str., Samara, Russian Federation, 443099, tel. +7-927-763-72-77, e-mail: igo71807805@yandex.ru

Objective. To analyze current literature on emergency care of patients with atrial fibrillation (AF) in  ambulance.

Material and methods. The analysis of current publications was carried out concerning the emergency care of patients with atrial fibrillation in  ambulance (PubMed, eLibrary, etc.)

Results. The current thematic sources were analyzed, the problems of organization and emergency care in ambulance were studied in detail. AF is known to be one of the most common cardiac arrhythmias constituting about 70% of their total amount. Emergency call is often the first medical contact for these patients, and ambulance tactic significantly impacts their further management.

Conclusions. Despite a large accumulated experience about AF at hospital stage, the way of further using this information for emergency help in ambulance is still uncertain. Current guidelines do not provide full understanding of the emergency care of patients with severe paroxysms of AF. There are no criteria of regulating tactics at the pre-hospital stage: from a patient’s first contact with medical service to transferring them to the next stage.

Key words: atrial fibrillation, ambulance, pre-hospital stage, emergency care.

(For citation: Polyakov I.A., Trukhanova I.G., Zinatullina D.S. Emergency care for patients with atrial fibrillation in ambulance: a modern view on the problem. Practical medicine. 2020. Vol. 18, №1, P. 13-17)

REFERENCES

1. 2016 ESC guildelines for the management of atrial fibrillation developed in collaboration with EACTS. European Society of Cardiology (ESC).European Heart Rhythm Association (EHRA) of the ESC. EurHeartJ., 2016, vol. 37, no. 38, pp. 2893-2962. DOI: https://doi.org/10.1093/eurheartj/ehw210
2. Klinicheskie Rekomendatsii po diagnostike i lecheniyu fibrillyatsii predserdiy. Vserossiyskoe nauchnoe obshchestvo spetsialistov po klinicheskoy elektrofiziologii, aritmologii i elektrokardiostimulyatsii (VNOA) v sotrudnichestve s Rossiyskim Kardiologicheskim obshchestvom (RKO) i Assotsiatsiey serdechno‐sosudistykh khirurgov, 2017 [Clinical Recommendations for the diagnosis and treatment of atrial fibrillation. All-Russian Scientific Society of Specialists in Clinical Electrophysiology, Arrhythmology and Electrocardiostimulation (VNOA) in collaboration with the Russian Society of Cardiology (RKO) and the Association of Cardiovascular Surgeons, 2017].
3. Klinicheskie Rekomendatsii po diagnostike i lecheniyu fibrillyatsii predserdiy. Vserossiyskoe Nauchnoe Obshchestvo spetsialistov po klinicheskoy elektrofiziologii, aritmologii i elektrokardiostimulyatsii (VNOA) v sotrudnichestve s Rossiyskim Kardiologicheskim obshchestvom (RKO) i Assotsiatsiey serdechno‐sosudistykh khirurgov, 2012 [Clinical Recommendations for the diagnosis and treatment of atrial fibrillation. All-Russian Scientific Society of Specialists in Clinical Electrophysiology, Arrhythmology and Electrocardiostimulation (VNOA) in collaboration with the Russian Society of Cardiology (RCO) and the Association of Cardiovascular Surgeons, 2012].
4. Skoraya meditsinskaya pomoshch’. Klinicheskie rekomendatsii, pod red. S.F. Bagnenko [Emergency medical care. Clinical recommendations, ed. by S.F. Bagnenko]. Moscow: GEOTAR-Media, 2019. 896 p.
5. Chugh S.S., Havmoeller R., Narayanan K., Singh D., Rienstra M., Benjamin E.J. et al. Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study. Circulation, 2014, vol. 25, no. 129(8), pp. 837–847. doi: 0.1161/CIRCULATIONAHA.113.005119.
6. Zoni-Berisso M., Lercari F., Carazza T., Domenicucci S. Epidemiology of atrial fibrillation: European perspective. ClinEpidemiol., 2014;6:213-20. doi: 10.2147/CLEP.S47385. eCollection,2014
7. Murphy A., Banerjee A., Breithardt G., Camm A.J., Commerford P., Freedman B., et al. The World Heart Federation Roadmap for Nonvalvular Atrial Fibrillation. GlobHeart, 2017, no. 12(4), pp. 273-284. doi:10.1016/j.gheart.2017.01.015
8. Kolbin A.S., Mosikyan A.A., Tatarskiy B.A. The socio-economic burden of atrial fibrillation in Russia: dynamics over 7 years (2010-2017). Vestnik aritmologii, 2018, no. 92, pp. 42-48 (in Russ.). DOI: 10.25760/VA-2018-92-42-48.
9. Plavunov N.F., Gaponova N.I., Kadyshev V.A., Abdrakhmanov V.R., Akimov A.E., Kulik A.I. Clinical and statistical analysis of patients with atrial fibrillation. Arkhiv» vnutrenney meditsiny, 2018, no. 8(5), pp. 389-393 (in Russ.). DOI: 10.20514/2226-6704-2018- 8-5-389-393
10. Luk’yanova I.Yu., Kuznetsov A.V., Komarnitskiy V.M. Medikamentoznaya kardioversiya u bol’nykh s paroksizmal’noy formoy fibrillyatsii predserdiy na dogospital’nom Clinical and statistical analysis of patients with atrial fibrillation. ConsiliumMedicum, 2017, no. 19 (12), pp. 38-41 (in Russ.). DOI: 10.26442/2075-1753_19.12.38-41
11. Pol’shakova I.L., Povetkin S.V. Comparative multidimensional characteristics of patients with atrial fibrillation observed in medical institutions of the city of Kursk and regions of the region. Nauchnye vedomosti BelGU. Meditsina. Farmatsiya, 2019, no. 1 (in Russ.).
12. Muromkina A.V., Nazarova O.A., Kachkina O.A., Cherevko E.Yu. Analysis of the provision of medical care for patients with atrial fibrillation in the city of Ivanovo. Vestnik IvGMA, 2016, no. 2 (in Russ.).
13. Guichard J.B., Xiong F., Qi X.Y., L’Heureux N., Hiram R., Xiao J., Naud P., Tardif J.C., Costa A.D., Nattel S. Role of atrial arrhythmia and ventricular response in atrial fibrillation induced atrial remodeling. Cardiovasc Res., 2020.
14. Kirchhof P., Lip G.Y., Van Gelder I.C. et al. Comprehensive risk reduction in patients with atrial fibrillation: Emerging diagnostic and therapeutic options. Executive summary of the report from the 3rd AFNET/EHRA consensus conference. Europace, 2012, no. 14, pp. 8-27.
15. Fatenkov O.V., Rubanenko O.A., Yashin S.S., Avezova D.B. Modern aspects of the concept, etiology, pathogenesis and prevention of sudden cardiac death. Nauka i innovatsii v meditsine, 2017, no. 2(6), pp. 20-25 (in Russ.).
16. Miyasaka Y., Barnes M., Gersh B.J., et al. Secular trends in incidence of atrial fibrillation in Olmsted County, Minnesota, 1980 to 2000, and implications on the projections for future prevalence. Circulation, 2006, no. 114(2), pp. 119-125. Doi:10.1161/CIRCULATIONAHA.105.595140
17. Khadzhibaev A.M., Makhamadaminov A.G., Nabiev A.A. Optimization of operational actions of ambulance dispatchers. Vestnik ekstrennoy meditsiny, 2015, no. 3 (in Russ.).
18. Davidenko J.M., Snyder L.S. Causes of errors in the electrocardiographic diagnosis of atrial fibrillation by physicians. J Electrocardiol., 2007, no. 40(5), pp. 450-456.
19. Miller O.N., Belyalov F.I. Tactics of patient management at the prehospital, inpatient and outpatient stages. Rossiyskiy kardiologicheskiy zhurnal, 2009, no. 4, pp. 94-111 (in Russ.).
20. Dudink E., Essers B., Holvoet W., Weijs B., Luermans J., Ramanna H., Liem A., van Opstal J., Dekker L., van Dijk V., Lenderink T., Kamp O., Kulker L., Rienstra M., Kietselaer B., Alings M., Widdershoven J., Meeder J., Prins M., van Gelder I., Crijns H. Acute cardioversionvs a wait-and-see approach for recent-onset symptomatic atrial fibrillation in the emergency department: Rationale and design of the randomized ACWAS trial. Am Heart J., 2017, no. 183, pp. 49-53. doi: 10.1016/j.ahj.2016.09.009. Epub 2016 Oct 2.
21. Capucci A., Compagnucci P. Is delayed cardioversion the better approach in recent-onset atrial fibrillation? No. Intern Emerg Med., 2020, no. 15(1), pp. 5-7. doi: 10.1007/s11739-019-02224-y. Epub 2019 Nov 13.
22. Drugs for atrial fibrillation. Med Lett Drugs Ther., 2019, no. 61(1580), pp. 137-144. https://secure.medicalletter.org/sites/default/files/freedocs/w1580a.pdf (6.12.2019).
23. Luk’yanova I.Yu., Kuznetsov A.V., Sokolov Yu.V. Medical cardioversion with propafenone in patients with a paroxysmal form of atrial fibrillation at the prehospital stage. Skoraya meditsinskaya pomoshch’, 2017, no. 2 (in Russ.).
24. Euwema M.S., Swanson T.J. Deadly Single Dose Agents.StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2020.
25. Trukhanova I.G., Zinatullina D.S., Polyakov I.A., Sadreeva S.Kh. Evaluation of the effectiveness of antiarrhythmic therapy with amiodarone for paroxysms of atrial fibrillation at the prehospital stage in different age groups of patients. Skoraya meditsinskaya pomoshch’, 2019, no. 20(1), pp. 30-34 (in Russ.).
26. Tarasov A.V., Kosykh S.A., Bushueva E.V. et al. Comparison of the effectiveness of injectable forms of antiarrhythmic drugs propafenone and amiodarone during pharmacological cardioversion of paroxysmal atrial fibrillation. ConsiliumMedicum, 2019, no. 21 (1), pp. 81-86 (in Russ.). DOI: 10.26442/20751753.2019.1.19028
27. Miller O.N., Syrov A.V., Doshchitsin V.L. et al. Clinical recommendations and expert opinion on the use of antiarrhythmic drugs in real practice. ConsiliumMedicum, 2019, no. 21 (5), pp. 43–50 (in Russ.). DOI: 10.26442/20751753.2019.5.190328