On August 1, a unique operation of subcutaneous implantation of a defibrillator in a patient with ventricular arrhythmia, ventricular fibrillation in the presence of hypertrophic cardiomyopathy and the risk of sudden death from cardiac arrest was performed at the Moscow Private Clinic of JSC Meditsina (clinic of Academician Roitberg). The operation was performed by a team of leading cardiac surgeons of JSC “Medicine” (clinic of Academician Roitberg) under the direction of Ardashev Andrey Vyacheslavovich and Kocharyan Armen Arturovich, with the clinical support of Professor Joachim Winter (Germany).

This was made possible thanks to the presence in JSC “Medicine” of the first and so far the only Angiographic installation of the latest generation Innova IGS 530 produced by GE Healthcare in Moscow, which allows surgeons to obtain better quality images using 3D modeling technologies. The installation allows you to perform a full range of interventions in any areas of the human body, aimed both at identifying vascular diseases and their treatment. In the fall of this year, together with the manufacturer of the angiographic installation Innova IGS 530, GE Healthcare is planning a scientific and practical conference. The Center for Cardiac Surgery in JSC “Medicine” (clinic of academician Roitberg) has existed since 2001. It employs specialists of the highest professional level, ready to constantly learn for themselves and share experience with colleagues.

“Traditionally, defibrillator implantation is done through the right chambers of the heart, passes through the tricuspid valve,” said the consultant of JSC “Medicine” (clinic of Academician Roitberg), arrhythmologist, MD, professor, Andrei Vyacheslavovich Ardashev. – An electrode is inserted inside the heart, which can lead to hemodynamic compromise and tricuspid valve failure. At JSC “Medicine”, the patient underwent a unique operation, which is minimally invasive, performed through a small incision, and the entire system is inserted subcutaneously. This technique minimizes the risks of infectious and other complications, compared with the traditional implantation method. “

“We always use advanced medical technologies, use the best medical equipment. But we are particularly proud of this operation, ”says Grigory Efimovich Roitberg, President of JSC“ Medicine ”, academician of the Russian Academy of Sciences. – Brilliant surgeons performed a unique operation, after which the patient was discharged from the hospital the next day. Now we can save people from death as a result of sudden cardiac arrest using modern methods of prevention. “

Ventricular fibrillation is a fast, irregular rhythm that occurs in the ventricles of the heart. Such a violation of the heart rhythm is considered life-threatening, since it can lead to sudden cardiac arrest, and requires immediate restoration of the rhythm by means of defibrillation – applying a high-energy electric discharge to the heart, which is not always possible. Therefore, early diagnosis and prevention of a high risk of sudden death from cardiac arrest is extremely important. As a rule, patients with problems with the cardiovascular system are observed by cardiologists and take drug therapy. Unfortunately, this does not guarantee absolute efficiency. Currently, prevention by implantation of cardiodefibrillators is considered to be proven – when the electrode is implanted endocardially, i.e. implanted right inside the heart. But there are a number of patients for whom the endocardial method is not desirable. For example, these are small children, or people of short stature of a slender physique. They grow, or their complexion changes and, accordingly, the geometry of the heart and the geometry of the device change. It is also important for patients who have a large mass of myocardium (heart muscle), with endocardial placement of electrodes, the defibrillation power may not be enough. The greater the mass of muscle tissue, the more difficult it is to make effective defibrillation, since it takes capture of a critical mass of the myocardium in order to restore normal heart rhythm. In such cases, it is necessary to place electrodes above the heart muscle, which in fact imitates external defibrillation and satisfies the necessary conditions.

The most significant risk factors for sudden deaths from cardiac arrest are the presence of malignant ventricular arrhythmias and decreased contractility of the left ventricle. Of the ventricular arrhythmias, ventricular fibrillation (flutter), which causes circulatory arrest, is most dangerous. Other risk factors include: a family history of coronary heart disease, old age, male gender, increased levels of total cholesterol, low density lipoproteins, hypertension, smoking and diabetes, and alcohol abuse.

About 17 million people die of cardiovascular disease each year in the world, and 25% of deaths occur through the mechanism of sudden cardiac death (BCC). In this regard, the problem of risk stratification and prevention of SCD is extremely relevant for domestic health care. In the vast majority of cases (85%), the mechanisms of SCD are ventricular tachyarrhythmias – ventricular tachycardia and ventricular fibrillation with the subsequent development of asystole. Today, modern technologies provide ample opportunities to use effective preventive measures aimed at improving the situation.

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In Moscow, for the first time, a unique operation was performed to implant a subcutaneous defibrillator pa …

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