Purpose — to study the effi cacy and safety of transesophageal atrial stimulation in combination with intravenous administration of amiodarone in comparison with pharmacological or device cardioversion in patients with typical atrial fl utter (AF). Material and methods. 129 patients with a typical paroxysmal or persistent AF were examined. The average patients age was 57.87 ± 7.43 years. The eff ectiveness and safety of pharmacological cardioversion with amiodarone iv, electrical cardioversion, transesophageal atrial stimulation, combined, if necessary, with intravenous amiodarone were compared. Conclusion. Statistically signifi cant diff erences were not found in the frequency of sinus rhythm achievement for diff erent types of a typical AF classical conservative treatment. The amiodarone addition during transesophageal atrial stimulation leads to a signifi cant increasing in the effi cacy in comparison with pharmacological cardioversion (p = 0.0380).

The review provides current ideas about the etiology and prevalence of atrial flutter (AF), mechanism and substrate of arrhythmogenesis, and principles of clinical and electrophysiological classification of this arrhythmia. Methods for conservative and surgical treatments of AF, including their comparative aspect, are described in detail. The review presented recent data on efficacy and potential risks of different approaches to reversing the arrhythmia. The authors indicated a need for early diagnosis and strict control of the sinus rhythm in AF, which would help a successful intervention not only to completely cure the existing arrhythmia but also to prevent other heart rhythm disorders, primarily atrial fibrillation.

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