Object of the study: coronary disease (CD), persisting and constant forms of atrial fibrillation (AF). Purpose of the study: to devise rational approaches to the therapy of different forms of AF in patients with CD using antiarrhythmic and antithrombotic drug preparations on the basis of studying peculiarities of arrhythmic predictors of AF development, as well as disorders in the coagulation and thrombocytes haemostasis. Methods of the investigation: general clinical examination, standard ECG, daily and double-daily ECG monitoring, echocardioscopy, determination of D dimer, determination of the aggregation capacity of thrombocytes, coagulogram, determination of lipid type, International Normalizing Proportion (INP). Theoretical and practical results: a method is suggested for a more effective revealing of arrhythmia predictors of the persisting form of AF with help of ECG monitoring during 48 hours. A complex study of plasma haemostasis, aggregation function of thrombocytes in patients with CD complicated with AF development was conducted against a background of complex (antiarrhythmic and antithrombotic) therapy. It was found out that the risk of thromboembolic complications was caused by preponderance and activation of the coagulation link of haemostasis; at the same time, a higher activity of the anticoagulant andfibrinolytic systems of the blood plasma was noticed. Disturbances in the haemostasis system of patients depending upon the form of AF were analysed. It was shown that the use of indirect anticoagulants required the choice of the op-timum dose; the latter ensures prevention of thrombosis with the minimum risk of haemorrhage, taking into consideration the basic therapy of the basic disease and leading factors of the risk of haemorrhagic complications. Novelty: an algorithm was devised for treating different forms of AF with dose-dependent use of antiarrhythmic (Amyodaron) and antithrombocytic (Aspirin, Varfarin) drug preparations with regard for INP, assessment of the clinical efficacy within the complex therapy. For the first time in Ukraine, the author used ECG monitoring during 48 hours in order to reveal the arrhythmic predictors of AF development, as well as to more effectively find out the persisting form of AF (Patent No. 22920, dated 25.04.2007, the application No. u 2007 00700). The part played by D dimer in the development of disorders of coagulation haemostasis in different forms of AF in patients with CD and a possible pharmacological effect on the above link were studied. The haemostatic parameters, which require the use of indirect coagulants (Varfarin) with the selection of the optimum dose, thereby ensuring thrombosis prophylaxis with the minimum risk of haemorrhages, taking into consideration the basic therapy of the basic disease and leading risk factors of haemorrhagic complica-tions. Degree of introduction: results of the research were introduced and are used in medical establishments of Kharkiv City and Re-gion: Infarction Department of Malaya Institute of Therapy of the Academy of Medical Sciences of Ukraine, Kharkiv City Central Hospital No. 11, central district hospitals of Balakleya, Izum, Blizniuki and Chuguev Districts of Kharkiv Region, as it is con-firmed by corresponding acts on introduction. Sphere of application: medicine, cardiology
