CardioSomaticsCardioSomaticsCardioСоматика2221-71852658-5707Eco-Vector4603710.26442/22217185.2020.1.200096ReviewsОбзорыReview ArticleMedical rehabilitation approaches in patients with implanted pacemakerПодходы к медицинской реабилитации пациентов с имплантированным электрокардиостимуляторомhttps://orcid.org/0000-0003-3786-7559IskenderovBakhram G.ИскендеровБахрам Гусейнович
Russian Federation

D. Sci. (Med.), Prof., Penza Institute for Advanced Medical Education – branch Russian Medical Academy of Continuous Professional Education

д-р мед. наук, проф., проф. каф. терапии, кардиологии, функциональной диагностики и ревматологии ПИУВ – филиала ФГБОУ ДПО РМАНПО

iskenderovbg@mail.ruhttps://orcid.org/0000-0002-9741-7333IvanchukovaMarina G.ИванчуковаМарина Геннадьевна
Russian Federation

Graduate Student, Penza Institute for Advanced Medical Education – branch Russian Medical Academy of Continuous Professional Education

аспирант каф. терапии, кардиологии, функциональной диагностики и ревматологии ПИУВ – филиала ФГБОУ ДПО РМАНПО

ivanchukovamg@yandex.ruhttps://orcid.org/0000-0002-1589-2799BerenshtejnNatalya V.БеренштейнНаталья Васильевна
Russian Federation

Cand. Sci. (Med.), Penza Institute for Advanced Medical Education – branch Russian Medical Academy of Continuous Professional Education

канд. мед. наук, доц. каф. терапии, кардиологии, функциональной диагностики и ревматологии ПИУВ – филиала ФГБОУ ДПО РМАНПО

berenshtein2011@yandex.ruPenza Institute for Advanced Medical Education – branch Russian Medical Academy of Continuous Professional EducationПензенский институт усовершенствования врачей – филиал ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России2609202011128342609202026092020Copyright ©; 2020, Eco-VectorCopyright ©; 2020, ООО "Эко-Вектор"2020Eco-VectorООО "Эко-Вектор"https://creativecommons.org/licenses/by-nc-sa/4.0https://cardiosomatics.ru/2221-7185/article/view/46037

In the following review article, the principles and approaches of medical rehabilitation in patients with implanted pacemakers are discussed. It was shown that total benefit results from cooperation among medical, physical and psychological components of rehabilitation program and optimisation of the mode and parameters of cardiac pacing. Social adaptation of the patients with implantable pacemakers is of paramount importance and should be directed on avoidance of external electromagnetic fields and their influence on pacemaker functions, which in turn may be life-threatening for patient and the staff as well. The indications to diagnostic and treatment regimens including physiotherapeutic procedures should be clearly defined in order to avoid potential influence of electromagnetic interference on cardiac pacemaker. The well-structured medical rehabilitation programs need to be organised in order to improve quality of life and patient′s survival with regard to growing tendency of implantation of cardiac pacemakers.

В обзорной статье обсуждаются принципы и подходы к медицинской реабилитации пациентов с имплантированным электрокардиостимулятором (ЭКС). Показано, что кумулятивный терапевтический эффект реабилитации у пациентов с ЭКС складывается из положительного влияния медикаментозной, физической и психологической реабилитации, а также определяется потенцированием их эффективности за счет оптимизации режима и параметров электростимуляции. Для успешной социальной адаптации пациентов важно учесть специфику трудовой реабилитации, которая исключает воздействие внешних электромагнитных полей на ЭКС, что чревато его отключением (ингибицией), представляющим угрозу для жизни самих пациентов и окружающего персонала. Одним из важных аспектов жизнедеятельности пациентов с имплантированным ЭКС является определение показаний и выполнение лечебно-диагностических процедур, в том числе физиотерапевтических методов, потенциально вызывающих электромагнитную интерференцию ЭКС. Неуклонный рост частоты имплантации ЭКС во всем мире диктует необходимость организации комплексной медицинской реабилитации, способствующей улучшению качества жизни и увеличению выживаемости пациентов.

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