Comparative analysis of phenomenology of paroxysms of atrial fibrillation and panic attacks

AIM: To study phenomenology of attacks of atrial fibrillation (AF) and to compare it with phenomenology of panic attacks for elucidation of pathogenesis of atrial fibrillation and for elaboration of rational therapeutic intervention including those aimed at correction of psychovegetative abnormalities. MATERIAL: Patients with nonrheumatic paroxysmal AF (n=105) and 100 patients with panic attacks (n=100). METHODS: Clinical, cardiological and neurological examination, analysis of patients complaints during attacks of AF, and comparison them with diagnostic criteria for panic attack. RESULTS: It was found that clinical picture of attacks of AF comprised vegetative, emotional and functional neurological phenomena similar to those characteristic for panic attacks. This similarity as well as positive therapeutic effect of clonazepam allowed to propose a novel pathogenic mechanism of AF attacks. Severity of psychovegetative disorders during paroxysm of AF could be evaluated by calculation of psychovegetative iudex: CONCLUSION: Psychovegetative index should be used for detection of panic attack-like component in clinical picture of AF paroxysm and thus for determination of indications for inclusion of vegetotropic drugs, e. g. clonazepam, in complex preventive therapy.