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Progress in the treatment of arrhythmias is associated with the development and implementation in clinical medicine of a number of electrophysiological methods that make it possible to determine and localize the formation and conduction of electrical excitation with a high degree of reliability. At the same time, an increase in the number of invasive procedures can lead to an increase in complications associated with the interventions, which in turn requires radiology specialists to understand the main stages of the intervention technique, and, accordingly, the mechanisms of development of possible complications and their localization. The purpose of the article is to present modern research data on the use of computed and magnetic resonance imaging in determining complications during interventional and surgical treatment of cardiac arrhythmias.

Aim. The study aimed to conduct a systematic review and meta-analysis of randomized clinical trials (RCTs) to determine the effect of pulmonary vein isolation (PVI) on the prognosis of patients with atrial fibrillation (AF) and chronic heart failure with reduced ejection fraction (HFrEF).Material and methods. We searched PubMed (MEDLINE), Google Scholar, and the Cochrane Library databases for studies that compared PVI with a conservative rhythm/heart rate (HR) control strategy in patients with AF and HFrEF. The primary endpoint in the major RCTs examining the effect of PVI on the prognosis of patients with HFrEF was a composite endpoint of all-cause mortality or HF-related hospitalization. Hazard ratios (HRs) based on Cox regression analysis were used as the baseline survival rates for the meta-analysis. To determine the weighted mean differences in improvement in left ventricular ejection fraction (LVEF) in the PVI and non-PVI groups, a pooled analysis of the mean LVEF changes with standard deviations taking into account the number of subjects in the compared groups was performed.Results. For this systematic review, 11 studies were selected from 2216 publications, which included 2379 patients. Three RCTs (n=968) were subjected to meta-analysis on time-to-event outcomes. The average follow-up period was 34 months. According to the meta-analysis, PVI was associated with a significant reduction in the risk of composite endpoint (HR: 0,53; 95% confidence interval (CI): 0,33-0,85; p=0,009). In addition, PVI compared with drug rhythm/rate control was associated with a significant reduction in the all-cause mortality risk (HR: 0,55; 95% CI: 0,34-0,89; p=0,01). Finally, a meta-analysis of 10 RCTs (n=1516) found a significant improvement in LVEF compared with drug rhythm/HR control or atrioventricular node ablation with biventricular pacing. The weighted mean difference in the LVEF change over time after 6-12-month follow-up was 5,25% (95% CI: 4,03-6,47; p