bluuebunny/crossref_metadata_2025_split huggingface dataset:
Atrial Reentry Tachycardia: Mechanisms and Diagnosis
Authors: Almiz Pavlo O. , Kravchuk Borys B. 
Published: December 2023

Atrial tachycardia (AT) is a group of arrhythmias that differ in electrophysiological mechanisms and clinical course. There are three main forms of AT: focal AT, macroreentries, and localized reentries also known as “microreentries”. Macroreentries, as a rule, occur in the presence of fibrous changes in the myocardium, for example, in “atrial” cardiomyopathy or as a result of catheter or surgical interventions in the atria. Focal AT can also occur in the absence of structural pathology of the heart.
The aim. To analyze modern ideas about electrophysiological mechanisms and diagnosis of atrial reentry tachycardia.
In our research we used data from the literature as well as findings of our own previous studies. The work analyzed global data on the distribution of various types of AT. The data of electrocardiographic (ECG) diagnosis, electrophysiological methods of diagnosis and pharmacological tests were also analyzed to determine the mechanism of occurrence and course of AT. The main ECG differences of different types and localizations of AT were determined. The diagnostic value of various stimulation protocols in the differential diagnosis of focal and macro-reentrant AT was also analyzed.
Conclusions. Atrial tachycardias with a reentrant mechanism are common in the general population. Differential diagnosis with other types of tachycardia is carried out on the basis of ECG data, the response to adenosine administration, the nature of the response during entrainment, and endocardial, particularly electroanatomical, mapping.
The Influence of Carbohydrate Metabolism Disorders on the Course of Perioperative Period in Cardiac Surgery Patients with Post-Infarction Left Ventricular Aneurysms
Authors: Gogayeva Olena K. 
Published: December 2023

The aim. To study the impact of carbohydrate metabolism disorders on perioperative period in cardiac surgery pa-tients with post-infarction left ventricular (LV) aneurysms.
Materials and methods. Retrospective analysis of perioperative period in random 132 patients with post-infarction LV aneurysms of various locations, who were operated on and discharged from the department of surgical treatment of ischemic heart disease of the National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine. Disorders of carbohydrate metabolism (DCM) were detected in 98 (74.2%) patients, among whom type 2 diabetes mellitus (DM) was diagnosed in 34 (25.7%) patients, impaired glucose tolerance (IGT) in 64 (48.5%). All the patients underwent general clinical examination, electrocardiography, echocardiography, coronary angiography and surgical treatment.
Results. When analyzing the clinical picture in patients with post-infarction LV aneurysms, painless myocardial isch-emia was diagnosed in 41 (31.06%) patients, among whom type 2 DM in 11 (26.8%) cases and IGT in 18 (43.9%). No statistically significant difference was found in patients with and without DCM in the LV contractile function, presence of LV thrombosis, atrial fibrillation, chronic kidney disease, stenosis of brachiocephalic arteries and arteries of the lower extremities, gouty arthritis, and body weight. Intraoperatively, diameter of the coronary arteries in patients with type 2 DM was slightly smaller compared to patients without DCM. Its increase in cases of calcification of coronary arteries and aorta among patients of the study group with DCM was statistically insignificant. A careful analysis of the postoperative period in patients with and without DCM showed a statistically significant occurrence of paroxysms of atrial fibrillation in 30 (90.9%) and 3 (9.1%) cases, respectively (p=0.0115). The patients with DCM had longer stay in the intensive care unit: 4.03 ± 2.3 vs. 3.2 ± 1.3 days (p=0.0483). Acute kidney injury in the early postoperative period occurred in 8 (6.06%) patients, including 5 (62.5%) with type 2 DM (p=0.0142). Sternal wound infection occurred in 2 (1.5%) patients with type 2 DM (p=0.0156).
Conclusions. Among cardiac surgical patients with postinfarction LV aneurysms, the major part is formed by patients with DCM (74.2%), the presence of which complicates the course of the postoperative period with the development of paroxysms of atrial fibrillation (p=0.0115), acute kidney injury (p=0.0142), sternal wound infection (p=0.0156), a long stay in the intensive care unit (p=0.0483).
Ductus Arteriosus Stenting as a Method of Palliative Treatment of Truncus Arteriosus Type A3: Literature Review and Clinical Case
Authors: Hura Tetyana Ye. , Mykhailovska Anzhelika O. , Motrechko Oleksandra O. , Maksymenko Andrii V. 
Published: December 2023

Introduction. Van Praagh A3 variant of truncus arteriosus (TA A3) is a condition when the one pulmonary artery branch origins from the TA, the other is filled through the patent ductus arteriosus (PDA).
PDA constriction in the early neonatal period can cause absence of blood supply to the one pulmonary artery branch. To prevent this, prolonged infusion of prostaglandin E1, PDA stenting or systemic-to-pulmonary shunt are used. These methods allow to postpone total repair (TR) and reduce mortality risks associated with neonatal period.
The aim. To analyze research papers dedicated to endovascular approach of TA A3 staged treatment and to present our own experience.
Materials and methods. We conducted a systematic literature search and analyzed various options for the TA A3 staged treatment. After the review, we used endovascular approach as the first stage of treatment in our clinical case.
We studied a newborn weighing 4 kg with TA A3 (left pulmonary artery branch origins from the non-coronary sinus of the truncal valve, right pulmonary artery branch filling through the PDA). Nakata index was 83 mm2/m2. McGoon ratio was 1. We decided to perform PDA stenting with the aim of postponing surgical correction until the patient’s optimal age and weight.
Discussion. In total, the number of publications about TA A3 staged treatment is limited. Most institutions prefer TA A3 staged treatment in newborns, because it is associated with a lower risk of complications than early TR. In our clinical case, the first step was PDA stenting. The staged approach allowed us to perform TR with a good result at the age of 3 months. Before TR, Nakata index and McGoon ratio were increased to 248 mm2/m2 and 1.9, respectively.
Conclusions. The current trend of TA A3 repair has few different options of staged treatment. Staged approach helps to get out of the newborn period and achieves the optimal condition for TR. Our patient successfully received PDA stenting as the first stage of treatment, which created conditions for the pulmonary artery branches growth. The second stage was TR with good long-term results. After analyzing the publications, we noted that the use of endovascular PDA stenting is a good and safe alternative to surgical palliative treatment.
Strategy of Surgical Correction of Postcoarctation Thoracic Aortic Aneurysms
Authors: Kravchenko Vitalii I. , Tarasenko Yurii M. , Derkach Alla V. , Kravchenko Ivan M. 
Published: December 2023

The aim. To analyze the experience of surgical treatment of postcoarctation aneurysms and to propose an optimal strategy in choosing a correction method.
Materials and methods. An analysis of 91 cases of postcoarctation aneurysm over a 25-year period was carried out. Eighty-five people (93.4%) were operated on, 6 patients (6.6%) were not operated on for various reasons. The patients were divided into clinical groups depending on the method: group I included 69 patients (75.8%) who underwent open correction of postcoarctation aneurysm. Group II consisted of 16 patients (17.6%) after endovascular or hybrid treatment.
Results. The obtained results demonstrated significant achievements and pronounced clinical effect of the performed surgical correction of postcoarctation aneurysms. We identified indications and contraindications for the correction of postcoarctation aneurysms by various methods: open, endovascular, and hybrid. It was found that the advantages of the endovascular technique are: minimally invasive approach, absence of a large surgical wound, shorter duration of the operation, faster activation of the patient after the intervention, shorter length of hospital stay in the postoperative period, faster return to a full active life. When studying the long-term results, based on the SF-36 questionnaire scores, it was established that the quality of life was higher among patients who underwent endovascular and hybrid correction of postcoarctation aneurysms.
Conclusion. Clear indications for surgical correction of postcoarctation aneurysm and the choice between open surgery, endovascular or hybrid intervention should be determined based on detailed analysis and with the participation of the entire heart team with mandatory consideration of: patient age, comorbidities, expected duration and quality of life of each patient after surgery.
Long-Term Results of Stenting in Patients with Hemodynamically Significant Lesions of the Left Main Coronary Artery
Authors: Levchyshyna Olena V. , Salo Sergii V. , Aksonov Yevhenii V. , Kyba Mykola S. 
Published: December 2023

The aim. To study the long-term results of stenting in patients with coronary artery disease with hemodynamically significant left main coronary artery (LMCA) stenoses.
Materials and methods. The study included 67 patients (56 men, 11 women) with a mean age of 63 ± 2.1 years.
Results. Among the 67 patients included in the study, 29 patients (43.3%) underwent percutaneous coronary inter-vention using a single-stent technique. These were patients with ostial LMCA lesions, lesions of the middle third of the LMCA and some patients with Medina 1.1.0; 1.0.1; 1.0.0; 0.1.0; 0.0.1 lesions of the distal part of the LMCA. The median follow-up was 2 years. Using a questionnaire, we managed to establish contact with 25 patients (86.2%). Among these, 1 patient (3.4%) died of non-cardiac causes and 7 patients (24.1%) had a recurrence of angina within 2 years. The causes of angina recurrence in 2 cases (6.9%) were restenosis in the stent with transition to the mouth of the side branch, which required repeated stenting of the LMCA with transition to the left circumflex artery. In 5 patients (17.2%), angina recur-rence was associated with progression of coronary atherosclerosis of another localization.
Among 67 patients with LMCA stenting, the two-stent technique was used in 38 patients (56.7%). These were pa-tients with Medina 1.1.0; 1.0.1; 1.0.0; 0.1.0; 0.0.1 lesions of the distal part of the LMCA. The median follow-up was 2 years. Using a questionnaire, we managed to contact 35 patients (92.1%). Among these, 4 patients (10.5%) died, but only one of them due to cardiac causes (2.6%), and 3 patients (7.9%) had recurrent angina within 2 years, two of whom underwent stenting by the T and protrusion (TAP) technique and one by culotte. The first two patients underwent angioplasty of restenosis in stents using balloons with a therapeutic coating. In the last patient, stent recoil in the left circumflex artery mouth was observed due to severe calcification, so this patient underwent re-implantation of the stent system in the recoil zone.
Conclusions. The problem of choosing a method of revascularization for patients with hemodynamically significant LMCA lesions remains controversial to this day, despite the wide range of evidence. Doctors should jointly decide on the choice of treatment methodology solely in the interests of the patient, taking into account all the factors that may affect the patient’s quality of life in the long term.
VAC Therapy as Part of Complex Treatment of Deep Sternal Wound Infection in Cardiosurgical Patients: First Experience
Authors: Osaulenko Vyacheslav V. , Chmul Karina O. , Budagov Rasim I. 
Published: December 2023

The aim. To improve the immediate and long-term results of treatment of cardiac surgery patients, by determining the feasibility of using wound therapy with negative pressure (vacuum assisted closure [VAC] therapy) as part of the complex tactics of postoperative management of patients with deep sternal wound infection (DSWI).
Materials and methods. A single-center, retrospective, observational study of the clinical data of 12 patients who underwent open-heart surgery using median sternotomy and who developed a DSWI was conducted. The mean age of the patients was 66.2 ± 2.2 years. The patients were divided into 2 groups, depending on the type of the treatment they received: group 1 included 5 (41.67%) subjects with the installation of a flow-washing system; group 2 included 7 (58.33%) subjects receiving negative pressure wound therapy.
Results. The use of VAC therapy contributed to the reduction of all indicators characterizing the course of the wound process, compared to patients treated with traditional methods. The duration of hospitalization was 36.2 ± 3.3 days in group 1 and 42 ± 4.0 days in group 2. The level of in-hospital mortality in the studied group receiving negative pressure wound therapy was 14.29% (1 patient) versus 80% (4 patients) in the group with flow-irrigation drainage.
Conclusions. Deep sternal wound infection is a very serious postoperative complication in cardiac surgical patients with a high in-hospital mortality rate. Diabetes mellitus, obesity, immunopathies are the main risk factors. VAC therapy in patients with DSWI allows to adequately repair the wound in a shorter time while maintaining the patient’s mobility, as well as to significantly reduce the duration of wound drainage and, as a result, the length of hospitalization.
Visualization of Left Ventricular Endocardium Activation Time during Cardiac Conduction System Pacing
Authors: Perepeka Eugene O. 
Published: December 2023

Introduction. Right ventricular myocardial pacing leads to asynchronous contraction of the left ventricle (LV) and can impair its contractility over time. Stimulation of the conduction system of the heart ensures physiological activation of the ventricles.
The aim. To visualize the pattern of propagation of the electrical front on the activation map of the LV endocardium during conduction system pacing and during right ventricular myocardial pacing.
Materials and methods. In two patients with the conduction system pacing, who were operated at the National Amosov Institute of Cardiovascular Surgery, invasive LV activation mapping was performed on various options of cardiac pacing using the EnSite Precision TM navigation system. One patient with complete atrioventricular block had nonselective His bundle pacing. The second patient had dilated cardiomyopathy and indications for cardiac resynchronization therapy and ablation of the atrioventricular junction due to chronic tachyform of atrial fibrillation. After an unsuccessful attempt to place LV lead in coronary sinus, a lead for left bundle branch pacing was implanted. Different activation maps of the LV endocardium were built in two patients with two types of cardiac pacing: right ventricular myocardial pacing and cardiac conduction system pacing.
Results. The total LV endocardial activation time was significantly different in the two studied patients with different pacing options. In a patient with non-selective stimulation of His bundle, the total LV endocardial activation time was 43 ms (QRS width 126 ms, the interval from the stimulus to the peak of the R wave in lead V6 78 ms). After switching to right ventricular myocardial pacing with a decrease in the pacing amplitude, the total LV endocardial activation time prolonged to 90 ms (QRS width 165 ms, the interval from the stimulus to the peak of the R wave in lead V6 117 ms). In a patient with left bundle branch pacing, total LV endocardial activation time was 51 ms (QRS width 160 ms, the interval from the stimulus to the peak of the R wave in lead V6 66 ms). With switching exclusively to right ventricular pacing the total LV endocardial activation time prolonged to 93 ms (stimulated QRS width 180 ms). At the same time, the activation pattern of the LV endocardium was significantly different, since the right ventricular lead was located closer to the apex.
Conclusions. Conduction system pacing provides rapid physiological LV activation and potentially avoids the negative consequences of asynchronous slow ventricular activation during right ventricular pacing.
Evaluation of Changes in the Quality of Life Using the U22 Questionnaire after Cavotricuspid Isthmus Ablation
Authors: Yakushev Andriy V. , Podluzhny Mykhaylo S. 
Published: December 2023

Abstract. Atrial tachyarrhythmias are the most common forms of heart rhythm disorders. According to literature sources, isolated atrial flutter (AFL) is observed in 88 people per 100,000 population. Most quality-of-life assessment methods have been developed and used primarily to assess atrial fibrillation. In this context, the U22 questionnaire becomes a significant protocol aimed at quantifying paroxysmal symptoms associated with tachyarrhythmias.
The aim. To evaluate changes in the quality of life in patients with typical AFL after radiofrequency ablation (RFA) and bidirectional conduction block through the cavotricuspid isthmus.
Materials and methods. The study is based on the analysis of the results of the treatment of a group of 135 patients at the National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine in the period from 2014 to 2021. The patients had three follow-up examinations, which were subject to analysis and static processing: before RFA (n=135), after 1 month (n=122) and after 1 year (n=81). All the patients were interviewed concerning their arrhythmia-related symptoms, which were assessed according to the U22 protocol.
Results. Before the procedure, the patients noted a low level of well-being (4.3±1.0 points). During the follow-up visit 1 month after RFA, the patients rated their general condition during this period at 8.9±0.7 points. The registered changes were statistically significant compared to the initial state (p<0.0001). Thus, the radical elimination of AFL led to rapid improvement in the psycho-emotional and physical condition of the patients as early as within 1 month. Similar changes were observed during the assessment after 1 year, when the patients assessed their condition at 9.3±0.7 points (p<0.0001); there was statistically significant difference compared to the initial condition and the results at the first follow-up examination. These results confirm the stability of the positive trend during the medium-term follow-up.
Conclusions. The U22 questionnaire found symptomatic improvement in patients undergoing RFA of cavotricuspid isthmus. The U22 questionnaire can be considered as another, additional control tool for patients who underwent RFA. The peculiarity of its application is the specificity of the assessment of paroxysmal symptoms and complaints, which are specifically related to rhythm disturbances, and the possibility of a simple analysis of the dynamics for a long time after the intervention.
Sequência Fedathi como trilha didática para promoção das competências de matemática da Base Nacional Comum Curricular
Authors: Silva Bruna Rafaela Araújo da , Moreira Marília Maia , Torres Antonia Lis de Maria Martins 
Published: December 2023

Este artigo tem como objetivo analisar as competências específicas e gerais do ensino de Matemática para o Ensino Fundamental apontadas na BNCC, tal como as características da prática da Sequência Fedathi encontradas em seus fundamentos. A pesquisa classifica-se como documental, exploratória, de caráter qualitativo, na qual a BNCC é o documento analisado. A análise documental foi realizada a partir de três etapas, de acordo com o método de análise de conteúdo de Bardin (1997). O referencial teórico se pautou em explorar os fundamentos e princípios da metodologia de ensino Sequência Fedathi; e, posteriormente, apresentar as competências da BNCC para o ensino de Matemática e como o documento define e compreende o conceito de competência. Como resultados, mostrou-se que as competências específicas e gerais para o ensino de Matemática da BNCC, a nível de Ensino Fundamental, têm forte relação com as nove características elencadas dos fundamentos e princípios da Sequência Fedathi. Como conclusões, a pesquisa evidenciou a relação de pelo menos duas características da Sequência Fedathi com cada competência específica de Matemática estabelecida pela BNCC para o Ensino Fundamental, podendo ser encontrada conexão com até oito das características apresentadas e que a característica nove se conecta com todas as competências estabelecidas; no que diz respeito às quatro competências gerais para o ensino de Matemática, as etapas Maturação e Solução desta metodologia são mais presentes nessas competências, pois é o momento no qual o aluno se coloca mais como protagonista da construção do seu conhecimento. Os resultados sugerem que o Letramento Matemático que tem como base as quatro competências gerais da BNCC, pode ser desenvolvido, fomentado e construído quando se utiliza de uma metodologia de ensino como a Sequência Fedathi, que estimula a participação diretamente do aluno na construção do conhecimento.
Political Modernization and Democratization in Croatia
Authors: Maldini Pero 
Published: December 2023

Abstract
This article deals with Croatian democratization as the most important process of its political modernization and identifies the main facilitating and inhibiting factors and their influence on its outcomes. The analysis is carried out at the sociostructural, institutional-political and sociocultural levels, while the outcomes of democratization are evaluated in relation to the features of a consolidated (substantive) democracy and the basic features of political modernization. It is shown that the specific sociostructural and sociocultural features – modeled by contingent factors – had a decisive influence on the context, processes and actors of democratization and its outcomes. It turns out that elite-driven democratization in such a specific context produced further limited modernization. Despite the normative-institutional consolidation and stability of democracy, incomplete sociostructural modernization and sociocultural adaptation, as well as democratic deficits, indicate that the political modernization of Croatian society and the state is still an open process.
Beyond Serb-Croat Apologies
Authors: Bachmann Klaus , Pavlaković Vjeran 
Published: December 2023

Abstract
One of the key themes in the three decades after the wars of Yugoslav dissolution has been reconciliation between Croatia and Serbia, two former Yugoslav republics that participated in the bloody fighting between 1991–1995 after Croatia declared independence. The recent inflation of the use of the term reconciliation requires a narrow and precise definition, which enables researchers and practitioners to adapt it to real-world cases and the available empirical evidence. In this article, the authors rely on the main features of the so-called “need-based model of socio-emotional reconciliation”, which was derived from social psychology to examine inter-group processes after violent conflict. They propose several amendments to this model to make it feasible for the analysis of inter-state relations, regarding reconciliation as a process, not a stable result of reconciliatory performances. They adopt this model to bilateral relations between Croatia and Serbia, with a focus on apologies related to the siege of Vukovar (1991) and the aftermath of Operation Storm (1995), and then discuss the model’s suitability for international relations theory.