Serediuk L. Patterns of management and treatment of patients with stable coronary heart disease with atrial fibrillation, taking into account the level of stress

First studied the level of psycho-emotional stress, anxiety and depressive disorders in patients with stable coronary heart disease with persistent and paroxysmal atrial fibrillation, which causes more severe clinical symptoms of atrial fibrillation, causing stress-induced atrial fibrillation. It is noted that the addition of mebicar to the standard of treatment and its combination with carvedilol has a positive effect on systolic function of the left ventricle, namely the ejection fraction increases and decreases the mass of the left ventricular myocardium. It was found that these treatment regimens showed positive dynamics of laboratory parameters: decreased levels of total cholesterol, β-lipoproteins of very low density, decreased concentration of cortisol and N-terminal fragment of the precursor of brain natriuretic peptide (NT-proBNP), and improves the dynamics of antioxidant enzymes. It was found that under the influence of standard treatment with anxiolytics in patients with stable coronary heart disease with persistent and paroxysmal atrial fibrillation, a positive effect of mebicar on the level of psycho-emotional stress, anxiety, depression, somatization disorders and reducing the incidence of social factors affecting health according to psychometric research methods. The feasibility of using β-blockers in the treatment of stable coronary heart disease with persistent and paroxysmal atrial fibrillation with high concentrations of NT-proBNP, which reduces myocardial remodeling processes, has been proven. The developed and applied treatment regimen (standard of treatment + mebicar; standard of treatment with carvedilol + mebicar) in patients with stable coronary heart disease with permanent and paroxysmal atrial fibrillation on the background of increased psychoemotional load was more effective than the standard of treatment. Key words: stable coronary heart disease, atrial fibrillation, scales, screening, stress, anxiety, depression, cortisol, mebicar, NT-proBNP. Branch – medicine.