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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">russjcardiol</journal-id><journal-title-group><journal-title xml:lang="ru">Российский кардиологический журнал</journal-title><trans-title-group xml:lang="en"><trans-title>Russian Journal of Cardiology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1560-4071</issn><issn pub-type="epub">2618-7620</issn><publisher><publisher-name>«SILICEA-POLIGRAF» LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.15829/1560-4071-2025-6775</article-id><article-id custom-type="edn" pub-id-type="custom">JILJIL</article-id><article-id custom-type="elpub" pub-id-type="custom">russjcardiol-6775</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ФИБРИЛЛЯЦИЯ ПРЕДСЕРДИЙ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ATRIAL FIBRILLATION</subject></subj-group></article-categories><title-group><article-title>Совершенствование оказания помощи больным с фибрилляцией предсердий</article-title><trans-title-group xml:lang="en"><trans-title>Improving healthcare delivery for patients with atrial fibrillation. Opinion on the problem</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2334-1663</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лебедев</surname><given-names>Д. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Lebedev</surname><given-names>D. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Лебедев Дмитрий Сергеевич – д.м.н., профессор РАН, заслуженный деятель науки РФ, г.н.с. НИО аритмологии, профессор кафедры сердечно-сосудистой хирургии факультета подготовки кадров высшей квалификации Института медицинского образования Центра Алмазова, врач — сердечно-сосудистый хирург, заслуженный деятель науки России</p><p>ул. Аккуратова, д. 2, Санкт-Петербург, 197341</p><p> </p></bio><bio xml:lang="en"><p>Akkuratova str., 2, St. Petersburg, 197341</p></bio><email xlink:type="simple">lebedevdmitry@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0008-0904-4495</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ермолов</surname><given-names>С. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Ermolov</surname><given-names>S. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ермолов Серафим Александрович – врач сердечно-сосудистый хирург отделения рентгенхирургического лечения сложных нарушений ритма сердца и электрокардиостимуляции </p><p>ул. Аккуратова, д. 2, Санкт-Петербург, 197341</p></bio><bio xml:lang="en"><p>Akkuratova str., 2, St. Petersburg, 197341</p></bio><email xlink:type="simple">ermolov-serafim@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБУ НМИЦ им. В. А. Алмазова Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Almazov National Medical Research Centre</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>22</day><month>03</month><year>2026</year></pub-date><volume>30</volume><issue>4S</issue><issue-title>Образование</issue-title><fpage>6775</fpage><lpage>6775</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Лебедев Д.С., Ермолов С.А., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Лебедев Д.С., Ермолов С.А.</copyright-holder><copyright-holder xml:lang="en">Lebedev D.S., Ermolov S.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://russjcardiol.elpub.ru/jour/article/view/6775">https://russjcardiol.elpub.ru/jour/article/view/6775</self-uri><abstract><p>Фибрилляция предсердий (ФП) остаётся одним из наиболее распространённых нарушений сердечного ритма и значимой медико-социальной проблемой, распространённость которой неуклонно растёт по мере старения населения. Влияние ФП связано с высоким риском инсульта, сердечной недостаточности, когнитивных нарушений и значительным снижением качества жизни, а также формирует выраженное экономическое бремя как за счёт прямых медицинских затрат, так и косвенных потерь. Современная стратегия ведения пациентов с ФП основывается на комплексном подходе, включающем стратификацию риска инсульта, применение прямых оральных антикоагулянтов, контроль сопутствующих факторов риска, а также выбор оптимальной тактики лечения. Новые данные свидетельствуют о преимуществах ранней стратегии контроля ритма, способствующей снижению сердечно-сосудистых событий, замедлению ремоделирования предсердий и снижению числа госпитализаций. Однако приверженность терапии остаётся низкой, а доступность плановой кардиоверсии, чреспищеводной эхокардиографии и катетерной аблации значительно варьирует между регионами.</p><p>Перспективные направления совершенствования помощи, обладающие высокой экономической эффективностью за счет снижения числа госпитализаций и серьезных осложнений, включают создание специализированных центров по ведению пациентов с ФП, развитие телемедицины и дистанционного мониторинга, расширение образовательных программ для специалистов стационарного и амбулаторного звена, расширение доступности плановой кардиоверсии и катетерной аблации, а также использование технологий искусственного интеллекта. Комплексный и системный подход, ориентированный на раннее вмешательство, коррекцию модифицируемых факторов риска, активное поддержание ритма и контроля приверженности терапии является ключевым инструментом повышения качества медицинской помощи пациентам с ФП и снижения нагрузки на систему здравоохранения.</p></abstract><trans-abstract xml:lang="en"><p>Atrial fibrillation (AF) remains one of the most common arrhythmias and a significant sociomedical problem, the prevalence of which is steadily increasing as the population ages. AF is associated with a high risk of stroke, heart failure, cognitive impairment, and a significant reduction in quality of life. It also creates a significant economic burden due to both direct medical costs and indirect losses. Current strategies for managing patients with AF are based on a comprehensive approach, including stroke risk stratification, the use of direct oral anticoagulants, control of associated risk factors, and the selection of optimal treatment strategies. Emerging data demonstrate the benefits of early rhythm control strategies, which help reduce cardiovascular events, slow atrial remodeling, and decrease the number of hospitalizations. However, adherence to treatment remains low, and the availability of elective cardioversion, transesophageal echocardiography, and catheter ablation varies significantly between regions.</p><p>Promising areas for improving care, which are highly cost-effective due to a reduction in hospitalizations and serious complications, include the creation of specialized centers for the management of AF patients, the development of telemedicine and remote monitoring, the expansion of educational programs for inpatient and outpatient specialists, increased availability of elective cardioversion and catheter ablation, and the use of artificial intelligence technologies. A comprehensive and systemic approach focused on early intervention, modification of risk factors, active rhythm control, and adherence monitoring is a key tool for improving the quality of care for patients with AF and reducing the burden on the healthcare system.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>эпидемиология фибрилляции предсердий</kwd><kwd>кардиоверсия</kwd><kwd>совершенствование помощи при фибрилляции предсердий</kwd><kwd>контроль ритма</kwd></kwd-group><kwd-group xml:lang="en"><kwd>atrial fibrillation epidemiology</kwd><kwd>cardioversion</kwd><kwd>improving atrial fibrillation care delivery</kwd><kwd>rhythm control</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Шапкина М.Ю., Маздорова Е.В., Авдеева Е.М. и др. Динамика частоты фибрилляции предсердий в российской популяционной выборке за 13 лет наблюдения. 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