2015


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2015/№2

Physical rehabilitation following early endovascular revascularization in patients with non-ST elevation acute coronary syndrome (NSTEACS) and ventricular rhythm disorders: Possibilities of the “upstream-therapy”

Lyamina N. P., Kotelnikova E. V.
Federal State Budgetary Institution, “Saratov Research Institute of Cardiology” at the RF Ministry of Health Care, Chernyshevskogo 141, Saratov 410028

Keywords: heart rhythm disturbances, non-ST elevation ACS, rehabilitation, transcutaneous coronary intervention

DOI: 10.18087/rhj.2015.2.2061

Background. The treatment strategy for non-ST elevation ACS (NSTEACS) following endovascular revascularization provides reduced risk of cardiovascular complications and improved prediction. Considering the heterogeneity of patients’ risk profile detailed elaboration of rehabilitation programs is required. Aim. To study safety and efficacy of physical rehabilitation, including moderate intensity, controlled exercise training (CET) and telemedical control, in combination with an “upstream-therapy” (Omacor 1000 mg / day)  in patients with NSTEACS and ventricular rhythm disorders (VRD) who have undergone a transcutaneous coronary intervention (TCCI). Materials and methods. The study included 36 patients with NSTEACS following early TCCI who had M. Ryan class II, III, IVA, and IVB VRD according to data of Holter ECG monitoring (ECG-HM) Patients of group I (n=20) performed CET of moderate intensity (60%) in combination with the additional Omacor 1000 mg treatment. Patients of group II performed only CET in combination with a standard therapy. The clinical stage included 10 daily CET sessions on a treadmill; the outpatient stage included the telemetric control of home-based moderate exercise for 10 weeks. Results. At 12 weeks, patients of group I (CET 60 % + Omacor 1000 mg) had a significant 1.5-fold decrease in VRD according to ECG-HM (1 956±360 vs. 3739±1162; р<0.05) along with increased peak oxygen consumption (POC), from 17.6±2.8 to 19.9±2.6 ml / kg / min (р<0.05). Conclusion. Development of rehabilitation programs including drugs for the “upstream-therapy” (Omacor 1000 mg / day) provides safe and effective conduction of outpatient physical training in patients with NSTEACS and VRD after TCCI.
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Lyamina N. P., Kotelnikova E. V. Physical rehabilitation following early endovascular revascularization in patients with non-ST elevation acute coronary syndrome (NSTEACS) and ventricular rhythm disorders: Possibilities of the “upstream-therapy”. Russian Heart Journal. 2015;14 (2):110–116

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