Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Ivano-Frankivsk National Medical University
Topicality. Atrial fibrillation (AF) is the most common chronic heart rhythm disorder, occurring in 1-2% of people in the general population. Stable coronary heart disease, hypertension, heart failure, obesity are risk factors for AF progression. Psycho-emotional stress, anxiety and depression can also cause AF.
Goal. To investigate the dynamics of the effectiveness of treatment of psychoemotional status in patients with persistent AF.
Materials and methods. We examined 62 patients with a permanent form of AF, treated in the cardiology department. Patients were divided into groups: group 1a - (n = 16), received basic therapy; 1b group - (n = 16), patients who in combination treatment received mebicar; Group 1b - (n = 15) patients who received carvedilol in addition to standard therapy; Group 1g (n = 15) consisted of patients receiving combination therapy with carvedilol and mebicar. In order to study the psychological state of patients with AF, L. Reeder"s scale of psychosocial stress, perceived stress-10, hospital scale of anxiety and depression (HADS) were used.
Results. The dynamics of the scale of perceived stress-10 in patients with a permanent form of AF in the dynamics of treatment showed a decrease in stress resistance after 2 weeks and a month and a half of treatment (p1 <0,001; p2 <0,001) (p1 - the significance of the difference compared to before and after p2 - the significance of the difference between the values compared with the value after 1.5 months of treatment (p <0,05) During treatment, the proportion of people with high and medium stress decreased by 31,43% in the group of standard treatment, and 39,95% in the group of patients where mebicar was used. It should be noted that in the same group before treatment was dominated by high levels of stress, and the average level was much less common. The share of high stress levels decreased from 53,34 to 6,66%. In this group of patients, the reduction in the score of stress was 17,78%. The level of stress in patients taking carvedilol decreased by 25,89%, and in the group where mebicar was used by 13,68%. Under the influence of standard therapy, the level of stress decreased by 13%, but this figure was not significant, despite the fact that in this group the number of patients decreased from high to medium stress. In the treatment of patients with anxiolytic drug should be noted a significant reduction in psychosocial stress (p1-2 <0,001).
It was found that against the background of psychopharmacotherapy in patients with AF there was a reduction from clinical to subclinical levels of anxiety and depression. It should be noted that the course of therapy with carvedilol adversely affected the course of anxiety and depression.
Conclusion. According to our study, psychometric parameters improved significantly against the background of comprehensive treatment in all groups of patients.