arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2021-27-1-7-15arthyper-2021Research ArticleСтатьиArticlesКлинические рекомендации по диагностике и лечению фибрилляции предсердий (2020): что нового для невролога?2020 ESC Guidelines for the diagnosis and management of atrial fibrillation: what is new for neurologists?https://orcid.org/0000-0002-6484-286XЯнишевскийС. Н.YanishevskiyS. N.

Янишевский Станислав Николаевич — доктор медицинских наук, доцент, заведующий научно-исследовательской лабораторией неврологии и нейрореабилитации ФГБУ НМИЦ им. В. А. Алмазова Минздрава России.

Санкт-Петербург

Stanislav N. Yanishevskiy - MD, PhD, DSc, Asssociate Professor, Head, Research Laboratory for Neurology and Neurorehabilitation.

St Petersburg

yanishevkiy_sn@almazovcentre.ruhttps://orcid.org/0000-0003-1955-1032СкибаЯ. Б.SkibaI. B.

Скиба Ярослав Богданович — кандидат медицинских наук, врач-невролог Научно-исследовательского института онкологии, гематологии и трансплантологии имени Р. М. Горбачевой ФГБОУ ВО ПСПбГМУ им. акад. И. П. Павлова Минздрава России.

Ул. Л. Толстого, д. 6–8, СанктПетербург, 197022

Iaroslav B. Skiba - MD, PhD, Neurologist, Research Institute of Oncology. Hematology and Transplantology n. a. R. M. Gorbacheva.

6–8 L. Tolstoy street, St Petersburg, 197022

yaver-99@mail.ruhttps://orcid.org/0000-0001-8699-2482ПолушинА. Ю.PolushinA. Y.

Полушин Алексей Юрьевич — кандидат медицинских наук, врач-невролог Научно-исследовательского института онкологии, гематологии и трансплантологии имени Р. М. Горбачевой, ассистент кафедры неврологии ФГБОУ ВО ПСПбГМУ им. акад. И. П. Павлова Минздрава России.

Санкт-Петербург

Alexey Y. Polushin - MD, PhD, Neurologist, Research Institute of Oncology. Hematology and Transplantology n. a. R. M. Gorbacheva.

St Petersburg

Федеральное государственное бюджетное учреждение Национальный медицинский исследовательский центр имени В.А. Алмазова Министерства здравоохранения Российской ФедерацииРоссияAlmazov National Medical Research CentreRussian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования Первый Санкт-Петербургский государственный медицинский университет имени академика И.П. Павлова Министерства здравоохранения Российской ФедерацииРоссияPavlov UniversityRussian Federation202106042021271715Copyright © Янишевский С.Н., Скиба Я.Б., Полушин А.Ю., 20212021Янишевский С.Н., Скиба Я.Б., Полушин А.Ю.Yanishevskiy S.N., Skiba I.B., Polushin A.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/2021

Клинические рекомендации по диагностике и лечению пациентов с фибрилляцией предсердий (ФП) являются одним из наиболее регулярно обновляемых документов, публикуемых под эгидой Европейского общества кардиологов. Новая версия клинических рекомендаций (2020) содержит в себе ряд изменений касательно проведения антикоагулянтной терапии у пациентов с ФП, у которых развилось острое нарушение мозгового кровообращения. В настоящем обзоре обсуждаются положения обновленного документа, посвященные срокам старта/рестарта антикоагулянтной терапии после перенесенных ишемического инсульта и внутричерепного кровоизлияния у пациентов с ФП, вопросу выбора антитромботической терапии у пациентов с криптогенным инсультом и необходимости дополнительного обследования данной группы пациентов для уточнения источника эмболии. Авторами обозначена позиция относительно возможности применения данных рекомендаций в реальной клинической практике с позиции баланса между персонифицированным подходом лечения пациента и стратифицированным принципом выбора оптимальных сроков старта/рестарта терапии антикоагулянтами у пациентов неврологического профиля.

Clinical practice guidelines for the diagnosis and management of atrial fibrillation (AF) are one of the most regularly updated documents by the European Society of Cardiology. The new version of clinical practice guidelines (2020) contains a number of changes regarding anticoagulant therapy in patients with AF who have developed acute cerebrovascular accidents. In this review, we discuss the statements of the updated document on the timing of the start/restart of anticoagulant therapy after ischemic stroke and intracranial hemorrhage in patients with AF, the choice of antithrombotic therapy in patients with cryptogenic stroke, as well as the need for the additional testing to clarify the origin of the embolism. We provide our original position on the possibility of applying these recommendations to the real clinical practice.

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The authors declare that there are no conflicts of interest present.