Komissarov S. Treatment of atrial fibrillation resistant to drug therapy.

On the base of clinical, haemodinamic and electrophysiological researches the assessment of outcomes of surgical treatment of atrial fibrillation (AF) in 926 patients has been done. The methods were permanent cardiac pacing, ablation of atrioventricular (AV) junction, atrial fragmentation by Cox maze and postoperative AF.The results of complex pacing systems application for AF prophylaxis were studied. Combined method of AF treating and prophylaxis including radiofrequency ablation of AV junction, pacemaker implantation, left atrium auriculum ligation with thoracoscopic technique has been suggested. Cox maze and criterion of patients choice are designed for valve surgery complicated with AF. Experimental model of paroxismal AF has been proposed. Influence of different kinds of atrial fragmentation on these model are studied. The outcomes of researches have allowed to elaborate algorithms of surgical tactics for treatment of AF. The original surgical classification of AF, envisioning a choice of surgical tactics in dependence on the AF form is designed.It is concluded that the surgical treatment is only a high-performance method for symptomatic patients, with AF refractory to drug therapy.