A.K. Baimbetov

https://orcid.org/0000-0003-4553-4287

Articles found: 2

  • The influence of pulmonary vein anatomy on outcomes after ablation of paroxysmal atrial fibrillation (Issue № 3, 2024)

    A. Baimbetov, A. Jukenova, A. Ualiyeva, K. Bizhanov, A. Sapunov, N. Bigeldiyev, K. Yakupova, N. Okhabekov, Zh. Meirambay
    2024-09-30
    82–89
    Abstract

    Background. Pulmonary vein isolation is the cornerstone of catheter-based treatment for atrial fibrillation. Cryoballoon ablation offers an effective and reproducible method for pulmonary vein isolation, yet recurrence of arrhythmias remains a challenge. Despite advances in catheter technologies, the role of altered pulmonary vein anatomy as a factor for atrial fibrillation recurrence is poorly studied. Materials and

    Methods. This prospective study included 465 patients with paroxysmal atrial fibrillation who underwent cryoballoon ablation. Pulmonary vein and left atrial anatomy were evaluated using multislice computed tomography. Patients were followed for 24–48 months to assess atrial fibrillation recurrence and anatomical risk factors. Cox proportional hazard modeling and Kaplan-Meier analysis were used to evaluate predictors of arrhythmia recurrence.

    Results. Complete Pulmonary vein isolation was achieved in all patients. During follow-up, 38% of patients experienced atrial fibrillation recurrence. Patients with altered pulmonary vein anatomy, particularly a left common pulmonary vein and additional pulmonary veins, showed a higher rate of recurrence. Cox regression analysis identified left atrial volume index >50 mL/m² and pathological pulmonary vein anatomy as independent risk factors for atrial fibrillation recurrence.

    Conclusion. Altered pulmonary vein anatomy is a significant risk factor for atrial fibrillation recurrence following cryoballoon ablation. Comprehensive imaging of the left atrial and pulmonary vein using multislice computed tomography can improve patient selection, reducing the recurrence risk and improving long-term outcomes.

    Keywords

    Atrial fibrillation, cryoballoon ablation, pulmonary vein anatomy, recurrence, pulmonary vein isolation, multislice computed tomography

  • WHAT SCALES SHOULD THE CARDIOLOGIST USE IN PATIENTS WITH ATRIAL FIBRILLATION? WHAT IS NEW? (Issue № 2, 2024)

    K.A. Bizhanov, A.K. Baimbetov, B.B. Baimakhanov, Sh.A. Kaniev, O.T. Ibekenov, A.B. Sarsenbaeva, G.N. Ismailova
    2024-06-28
    61–77
    Abstract

    The current treatment algorithm for patients with non-valvular atrial fibrillation (AF) includes anticoagulation to prevent stroke and systemic embolism, improvement of AF symptom control by heart rate reduction or restoration and maintenance of sinus rhythm, and treatment of cardiovascular and other comorbidities. The evaluation of patients with AF should be structured and include assessment of stroke risk, symptom severity, severity of the AF burden (type of arrhythmia, number and duration of episodes, etc.) and predisposing condition. The use of the CHA2DS2-VASc (risk of stroke), HAS-BLED (risk of bleeding), EHRA (severity of AF symptoms), and 2MACE (risk of cardiovascular outcomes) scales is important to help assess the likelihood of adverse outcomes and select the optimal treatment to protect not only against stroke but also against cardiovascular events. It should be noted that the HAS-BLED scale is primarily necessary for identification of bleeding risk factors, the modification of which allows to increase the safety of anticoagulant therapy, and a high index value according to this scale can’t serve as a reason to refuse anticoagulation in a patient with AF. New scales of stroke and hemorrhagic complications risk assessment in patients with AF on the basis of clinical parameters and laboratory biomarkers have been proposed, but their possible advantages over the existing indices need to be confirmed in special studies.

    Keywords

    Atrial fibrillation, stroke, bleeding, scales, direct oral anyicoagulants, myocardial infarction, interventional arrhythmology, cardiology