[Effect of clonazepam and antiarrhythmic drugs on heart rate variability in patients with paroxysmal atrial fibrillation].

Aim: To study direction and intensity of autonomic changes in patients with paroxysmal atrial fibrillation (PAF) treated with clonazepam and their dynamics during antiarrhythmic therapy.

Material: Patients with nonrheumatic PAF during effective clonazepam monotherapy or ineffective antiarrhythmic therapy (n=95), untreated patients with PAF (n=22), healthy persons (n=10).

Methods: Clinical cardiological and neurological examination, assessment of the state of autonomic nervous system, emotional sphere, patterns of sleep, and spectral analysis of heart rate variability (HRV).

Results: Effective monotherapy with clonazepam was associated with clinical and psychovegetative improvement, positive changes of autonomic tone and normalization of vegetative support of activity of patients with PAF. Analysis of HRV showed that ineffective (insufficiently effective) antiarrhythmic therapy was associated with stabilization of cardiac rhythm and domination of ergotropic activation which correlated with severity of psychovegetative syndrome. This could be considered as indication for supplementary use of clonazepam.

Conclusion: Analysis of HRV confirmed expediency of the use of clonazepam in patients with PAF both as monotherapy and in combination with ineffective antiarrhythmic therapy.