Aim. To verify the effectiveness of surgical ablation for atrial fibrillation by irrigated unipolar radiofrequency, applied to both atria, for the reversal and maintenance of the sinus rhythm in the short and medium term in patients undergoing concomitant cardiac surgery.

Material and methods. Between February 2008 and March 2012 a total of 35 consecutive patients with persistent and permanent paroxysmal AF underwent surgical tachyarrhythmia ablation by irrigated unipolar radiofrequency applied biatrially with concomitant cardiac surgery. All cases were diagnosed at least 12 months before the procedure and the group consisted of 15 (42,8%) male and 20 female (51,2%) patients, aged 25-78 years (52,23±12,82).

Results. There were 24 (68,5%) patients with rheumatic mitral valve disease with 25,8% with degenerative disease. The left atrial diameter measured by transthoracic echocardiography ranged from 44 to 70 millimeters (mm) (55,31±18,10).There were two hospital deaths in this series. Upon discharge, we observed the following rhythms and percentages: 24 (68,5%) — sinus rhythm, 7 (20%) — AF and 4 (11,5%) — junctional rhythm. At medium term follow-up we obtained the following results: 11 (73,3%) — sinus rhythm, 2 (13,35%) — junctional rhythm and 2 (13,35%) — AF.

Conclusion. Surgical ablation by irrigated unipolar radiofrequency applied to both atria is effective in the reversal and maintenance of sinus rhythm during short and medium term follow-up.

Aim. Coronary artery bypass grafting (CABG) is a procedure used to help improve and save the lives of thousands of coronary artery diseases patients every year. Measuring psychological status of patients, significantly contributes to understanding patient perceptions of outcomes attributable to this surgery. The aim of this study was comparison of psychological status s of patients before and 3 months after CABG.

Material and methods. In this cross sectional study a total of 120 consecutive patients who submitted to CABG were examined a few days before and 3 months after CABG at the Ekbatan hospital in Hamadan/Iran in 2012. The SCL-90 Questionnaire was used to measure psychological dimensions pre and post CABG. Data analysis was performed using SPSS version 18. Paired t-tests were used to compare pre-operative and postoperative SCL-90 scores.

Results. Significant differences were found between before and after CABG in patients’ scores of somatization, obsession-compulsion, interpersonal sensitivity, depression and Anxiety subscales (p<0,001) of the SCL-90 Questionnaire.

Conclusion. Preoperative assessment could identify patients at risk for clinical levels of postoperative psychological problems. Detection of psychological symptoms during the pre- operative evaluation was essential for diagnostic orientation and, if needed, counseling and therapeutic interventions could be instituted.

Aim. Evaluate the acute effects of a standardized exercise with flexible pole on cardiac autonomic regulation.

Material and methods. We evaluated 23 women between 18 and 25 years old and heart rate variability (HRV) was analyzed in the time (SDNN, RMSSD and pNN50), frequency domain (HF, LF and LF/HF ratio) and geometric analysis (RRTri, TINN, SD1, SD2 and SD1/SD2). The subjects remained at rest for 10 minutes. After the rest period, the volunteers performed the exercises with the flexible poles. Immediately after the exercise protocol, the volunteers remained seated at rest for 60 minutes and HRV were analyzed.

Results. We observed no significant changes in the time domain and frequency domain indices of HRV between before and after single bout of exercise with flexible pole.

Conclusion. A single bout of exercise with flexible pole did not induce significant change in geometric and linear indices of HRV.

Aim. The aim of this study was to evaluate the effect of flexible pole exercise on cardiac autonomic modulation. This was investigated while at rest before and, then in the recovery phase from the flexible pole exercise.

Material and methods. Thirty-two female subjects were allocated to equal groups. The analysis of cardiac autonomic modulation was through the recording of temporal separations of interpeak RR intervals taken from the heart rate monitor. The analysis was performed by chaotic global measures of heart rate variability (HRV). Two parameters were proposed based on the greater resolution of multi-taper method (MTM) power spectra. They were high spectral entropy (hsEntropy) and high spectral detrended fluctuation analysis (hsDFA) and were applied owing to the greater parametric response in short data series. After applying Anderson-Darling and Lilliefors tests for confirmation of high non-normality; Kruskal-Wallis test of significance was used for the statistical analysis, with the level of significance moderately set at (p<0.15).

Results. On recovery from flexible pole exercise there was a significant decrease in three of the combinations of CFP. The algorithm which applied all three chaotic global parameters was the optimum statistically measured by Kruskal-Wallis and standard deviation. It was also the most influential by principal component analysis (PCA) with almost all variation covered by the first two components.

Conclusion. Flexible pole exercise leads to a further significant decrease in chaosity measured by the combination of chaotic globals.

We assessed the prevalence of obesity and identify obesity-related markers of elevated/high cardiovascular risk among urban employed Mongolians. 1277 railway workers aged 18-63 were investigated. Obesity parameters, blood pressure, lipids and fasting plasma glucose levels were measured. Body composition by bioelectrical impedance method was evaluated. 10-year risk for cardiovascular events was calculated. The results showed that the prevalence of general obesity was 65,4% in men and 68,5% in women. Abdominal obesity was found in 58,5% of men and 76.1% of women. By ROC-analysis we revealed the obesity-related markers with the best diagnostic accuracy for elevated/high cardiovascular risk assessed by the Systematic Coronary Risk Evaluation, Framingham Heart Study and Atherosclerotic Cardiovascular Disease risk algorithms. For men they were waist circumference waist-to-height ratio, for women — the body fat percentage. The optimal cut off values for these predictors and corresponding odds ratios for risk increase were determined.

Aim. In this study we evaluated the metabolic syndrome (MetS) prevalence and its structure in Mongolian urban employed population.

Material and methods. The prevalence of MetS, defined by IDF (2005), JIS (2009) and modified NCEP ATP III (2004) criteria, was estimated in 1277 Mongolian railway workers (737 men and 540 women) aged 18 years or older.

Results. The MetS prevalence by IDF (2005) definition was found to be 36,1% in men and 39,6% in women, by JIS (2009) — in 38,9% and 40,9% and by NCEP ATP III (2004) — in 25,1% and 35,0% respectively. Abdominal obesity was the most common component (58,5% in men and 76,1% in women) as well as a constellation of abdominal obesity, elevated blood pressure and high serum triglycerides was the most common variant in MetS structure (51,9% in men and 30,4% in women).

Conclusion. Mongolian railway employees were characterized by high rate of MetS, which can be accounted for professional stress and changes in the lifestyle due to urbanization. The highest common components of MetS were found to be abdominal obesity, hypertension and hypertriglyceridemia.

Aim. The implantable cardioverter-defibrillator [ICD] has been proven to reduce the risk of sudden cardiac death through the termination of ventricular fibrillation and life-threatening ventricular tachycardia. The simplest measure of defibrillation effectiveness is the DFT, defined as the lowest delivered shock strength required to defibrillate. Improved technology and use of ICDs for primary prevention have led some to question the need for either defibrillation testing or any assessment of defibrillation efficacy after implantation. Experts disagree about optimal testing because data are insufficient to define the trade-off between accuracy and risk of testing. However there are specific cases in which DFT is necessary.

Material and methods. Authors describe the case of a patient with persistent left vena cava, a rare congenital anomaly, with no clinical importance which is usually accidentally revealed during the implantation of pacemaker or when placing a central vascular catheter. However, it represents a major problem and challenge for positioning of the standard pacemaker electrodes.

Results. After a successful implantation via unconventional anatomic path authors carried out DFT testing to check that the device is functioning appropriately.

Conclusion. Persistent left vena cava should not represent a contraindication for implantation of complex pacemaker systems such as ICD and DFT testing is advisable in this cases.

Acute coronary disease diagnostics improvement is a worldwide priority. The introduction of a promising method of study of the electromotive force of the heart with the use of information technologies, allows us to diagnose acute myocardial infarction. We have used a modern cardiodiagnostics complex MTM-SKM by Severodonetsk Scientific Production Association “Microtherm” (Ukraine).

Clinical case. The presence of vectorcardiography necrobiotic processes in the left ventricle apical region, intraventricular conduction and hemodynamic overload of the atria has been revealed at the patient D., 59, with acute myocardial infarction, which was additional information that has not been registered on the ECG.

Conclusion. Vector electrocardiography, allows us to investigate the periodic distribution of the electromotive force in dynamics over the entire surface of the heart, and also makes it possible to obtain detailed information about the functional state of the myocardium, specifying the depth and extent of the pathological process.

82-year-old patient with arterial hypertension and chronic obstructive lung disease was admitted to cardiac ward due to second — degree atrioventricular block in order to pacemaker implantation.

Giant left atrium (GLA) is defined as those measuring larger than 8 cm and are typically found in patients who have rheumatic mitral valve disease with severe regurgitation. GLA is a rare condition, with a reported incidence of 0,3%.The patient usually presents with complaints of shortness of breath and/or dysphagia. The correct diagnosis of GLA is at times not possible through the routine chest roentgenogram and may require echocardiography, computerized tomography or cardiac MRI to reach a diagnosis. GLA is associated with complications such as heart failure, valvular heart disease, dislocations of electrode. Patients with GLA are candidates for surgical/catheter interventional treatment at any age.