The objective is to investigate the influence of stress on the clinical and pathogenetic peculiarities of the course of stable coronary heart disease (SIHD) in conjunction with atrial fibrillation (AF). Materials and methods. The analysis of psychodiagnostic tests, labolatory and instrumental research methods in patients with and without AF has been performed. Patients were divided into three groups: group 1 – patients with stable ischemic heart disease (SIHD) with a constant form of AF (15 patients were examined), group 2 – patients with SIHD with paroxysmal form of AF (16 patients were examined), group 3 – patients with SIHD without AF (15 patients were examined). Results. According to the analysis of the data obtained, low level of stress was found in 6 (37.50%) patients with a permanent form of AF, whereas in patients without AF, it was observed in 1 (6.67%) person (p1<0.05) (p1 – the reliability of the differences in indicators relative to patients without AF). Moderate somatic disorder in women with paroxysmal AF was significantly higher than in the group of patients with a constant form of AF (p2<0.05) (p2 – the reliability of the differences in the indicators relative to patients with a constant form of AF). It is confirmed in patients with AF there are signs of the average stress level on the perceived stress level-10 (p2<0.05). Among the social factors that may have an impact on health are the influence of the media, the use of alcohol by relatives, the threat of unemployment for relatives and friends. These indicators were most often found in the group of patients with AF rather than without it (p2<0.05). Changes of ECG and echocardiographic parameters in all groups of patients were revealed. Conclusion. The association of stress with stable ischemic heart disease combined with atrial fibrillation has shown that stress disorders are associated with an increased risk of atrial fibrillation and may worsen their course and predict the risk of developing paroxysm. The dependence between the severity of clinical manifestations, psychodiagnostic tests, laboratory methods, ECG and echocardiographic parameters of the heart on the course of atrial fibrillation is proved.

Atrial fibrillation is a disturbance of heart rhythm, which is characterized by frequent contractions of atrial muscle fibers. Stable ischemic heart disease, arterial hypertension, heart failure, obesity are risk factors for progression of atrial fibrillation. Psycho-emotional stress, anxiety and depression can be the cause of atrial fibrillation paroxysm as well.          The objective of the research was to study the effect of mebicаr in the treatment of paroxysmal atrial fibrillation considering anxiety-depressive symptoms.      Materials and Methods. Observations were performed on patients with stable ischemic heart disease and co-existent paroxysmal atrial fibrillation using clinico-psychopathological research method (structured interview). The level of stress was determined on the L. Rider scale and the 10-Item perceived stress scale; the level of anxiety and depression was determined by means of the Hospital Anxiety and Depression Scale and the Patient Health Questionnaire-9. The evaluation of the free radical oxidation state was carried out using a spectrophotometric method to determine the activity of catalase, glutathione peroxidase, superoxide dismutase in the blood serum.           Results. As a result of the analysis, it was found that the higher the level of anxiety-depressive disorders, the more frequent paroxysms of atrial fibrillation. High level of stress was found in 37.50% of men (p<0.01) and 31.25% of women (p<0.05) in Group 2b. The manifestations of the clinical level of anxiety and depression in men of Group 2b (p<0.05) were detected.          Conclusions. The analysis of electrocardiogram indices showed the signs of atrial fibrillation (p<0.05), repolarization abnormalities (p<0.001), left ventricular hypertrophy (p<0.05), and the appearance of extrasystoles (p<0.001). Echocardiographic indices showed the signs of diffuse cardiosclerosis, severe left atrial dilatation (p<0.05) and reduced myocardial contractility, which was statistically confirmed. The use of anxiolytic medication – mebicar – during treatment helped significantly improve the clinical and hemodynamic parameters, which confirmed treatment effectiveness.