Modern strategies for optimizing the management of patients with myocardial infarction and atrial fibrillation

The aim of the study – to analyze and summarize information from the scientific literature on modern approaches to the management of patients with acute myocardial infarction and atrial fibrillation, as well as to identify promising directions for research in this category of patients. Materials and methods. We searched in the scientometric systems of Google Scholar, PubMed, Cochrane Database, conducted a synthesis, comparison, generalization and system-structural analysis of modern scientific literary sources. Results. The analysis of information in the modern scientific literature demonstrates that patients with combined cardiovascular pathology, in particular acute myocardial infarction with atrial fibrillation (AF), have a higher risk of mortality, a higher frequency of repeated cardiovascular events and a severe course of the underlying disease, which complicates the management of this category of patients. Despite all efforts to improve the AF management system, in the last decade the incidence of AF continues to grow, the age of patients is decreasing, the number of patients with two or more cardiovascular disease risk factors rises, which increases the frequency of AF-related complications. The use of mobile applications to solve clinical tasks in patients with AF has proven its effectiveness and is actively used in practice. Among the components of myocardial infarction and AF management, revascularization, drug treatment and rehabilitation have the highest level of evidence and significantly reduce mortality. It should be noted that existing rehabilitation protocols do not include restorative treatment programs for patients with combined cardiovascular pathology. Different rehabilitation strategies for myocardial infarction and atrial fibrillation create difficulties in managing these pathologies in combination. Conclusions. Optimizing the management of patients with myocardial infarction and atrial fibrillation through the development of rehabilitation programs will help unify the approach to this category of patients. The use of telemedicine elements for rehabilitation treatment will expand the limits of patients’ access to cardiac rehabilitation resources, increase their adherence and improve treatment effectiveness.