Russian MedicineRussian MedicineРоссийский медицинский журнал0869-21062412-9100Eco-Vector4417810.18821/0869-2106-2019-25-5-6-309-315ArticlesСтатьиResearch ArticlePROTOCOL FOR PRESCRIBING ANTICOAGULANTS FOR ATRIAL FLUTTER: ARE ALL ISSUES RESOLVED?ПРОТОКОЛ НАЗНАЧЕНИЯ АНТИКОАГУЛЯНТОВ ПРИ ТРЕПЕТАНИИ ПРЕДСЕРДИЙ: ВСЕ ЛИ ВОПРОСЫ РЕШЕНЫ?ZotovaIrina V.ЗотоваИрина Вячеславовна

candidate of medicine science, assistant professor, department of therapy, cardiology and functional diagnostics, Central State Medical Academy of Department of Presidential Affairs, 121359, Moscow, Russian Federation; cardiologist, heard of Center for Individualized Prevention and Treatment of Arterial and Venous Thrombosis City Clinical Hospital №17 of Moscow Healthcare department, 119620, Moscow, Russian Federation

канд. мед. наук, доцент, доцент кафедры терапии, кардиологии и функциональной диагностики ФГБУ ДПО «Центральная государственная медицинская академия» Управления делами Президента РФ 121359, Москва; врач-кардиолог, руководитель Центра индивидуализированной профилактики и лечения артериальных и венозных тромбозов ГБУЗ «Городская клиническая больница № 17» ДЗМ, 119620, Москва

irinazotova@bk.ruCenter for Individualized Prevention and Treatment of Arterial and Venous Thrombosis City Clinical Hospital № 17Центр индивидуализированной профилактики и лечения артериальных и венозных тромбозов ГБУЗ «Городская клиническая больница № 17» ДЗМCentral State Medical Academy of Department of Presidential AffairsФГБУ ДПО «Центральная государственная медицинская академия» Управления делами Президента РФ15122019255-6VOL 25, NO5-6 (2019)ТОМ 25, №5-6 (2019)30931514092020Copyright ©; 2019, Eco-VectorCopyright ©; 2019, ООО "Эко-Вектор"2019Eco-VectorООО "Эко-Вектор"https://medjrf.com/0869-2106/article/view/44178

The article is devoted to the issue of prescribing long-term anticoagulant therapy for patients with atrial flutter. Currently, a unified approach to prescribing anticoagulants for atrial flutter and fibrillation is generally accepted. However, this approach does not have strong evidence. The article provides a comparative analysis of the risk of thromboembolic complications and left atrium thrombosis in atrial flutter and fibrillation, discusses possible mechanisms of these differences. The results of studies confirming and refuting the unified approach to anticoagulant therapy for these arrhythmias are discussed. The author’s clinical protocol for prescribing long-term anticoagulant therapy to patients with atrial flutter is presented. a comparative analysis of current clinical recommendations on this problem is carried out.

Статья посвящена вопросу назначения длительной антикоагулянтной терапии больным с трепетанием предсердий. В настоящее время общепринятым является унифицированный подход к назначению антикоагулянтов при трепетании и фибрилляции предсердий. Тем не менее, данный подход не имеет строгих доказательств. В статье проводится сравнительный анализ риска развития тромбоэмболических осложнений и образования тромба в левом предсердии при трепетании и фибрилляции предсердий, обсуждаются возможные механизмы данных различий. Обсуждаются результаты исследований, подтверждающих и опровергающих унифицированный подход к антикоагулянтной терапии при этих аритмиях. Представлен авторский клинический протокол назначения длительной антикоагулянтной терапии пациентам с трепетанием предсердий, проводится сравнительный анализ современных клинических рекомендаций, посвященных данной проблеме.

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