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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">pirogovestnik</journal-id><journal-title-group><journal-title xml:lang="ru">Вестник Национального медико-хирургического центра им. Н.И. Пирогова</journal-title><trans-title-group xml:lang="en"><trans-title>Bulletin of Pirogov National Medical &amp; Surgical Center</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2072-8255</issn><issn pub-type="epub">2782-3628</issn><publisher><publisher-name>Национальный медико-хирургический Центр им. Н.И. Пирогова</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.25881/20728255_2025_20_1_98</article-id><article-id custom-type="elpub" pub-id-type="custom">pirogovestnik-272</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОРЫ ЛИТЕРАТУРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEWS</subject></subj-group></article-categories><title-group><article-title>КОНТУРЫ СОВЕРШЕНСТВА: ЭВОЛЮЦИЯ ТЕХНИК И РЕЗУЛЬТАТЫ ИЗОЛЯЦИИ ЛЕГОЧНЫХ ВЕН С НОВЫМ КРИОБАЛЛОНОМ</article-title><trans-title-group xml:lang="en"><trans-title>CONTOURS OF PERFECTION: EVOLUTION OF TECHNIQUES AND OUTCOMES OF PULMONARY VEIN ISOLATION WITH A NEW CRYOBALLOON</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Вирстюк</surname><given-names>Ю. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Virstyuk</surname><given-names>Yu. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Москва</p></bio><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">danmed@bk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шугушев</surname><given-names>З. Х.</given-names></name><name name-style="western" xml:lang="en"><surname>Shugushev</surname><given-names>Z. H.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Москва</p></bio><bio xml:lang="en"><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ЦКБ «РЖД-Медицина»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Central Clinical Hospital «RZD-Medicine»</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>09</day><month>03</month><year>2025</year></pub-date><volume>20</volume><issue>1</issue><fpage>98</fpage><lpage>102</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Вирстюк Ю.В., Шугушев З.Х., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Вирстюк Ю.В., Шугушев З.Х.</copyright-holder><copyright-holder xml:lang="en">Virstyuk Y.V., Shugushev Z.H.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://submit.pirogov-vestnik.ru/jour/article/view/272">https://submit.pirogov-vestnik.ru/jour/article/view/272</self-uri><abstract><p>Фибрилляция предсердий (ФП) является одной из наиболее распространенных форм аритмий, затрагивающей около 1–2% населения. Ожидается, что в ближайшие десятилетия ее распространенность заметно увеличится ввиду старения населения. ФП оказывает негативное воздействие на качество жизни и сердечную функцию, увеличивая риск смерти. Катетерная абляция стала ключевым методом лечения ФП, особенно для достижения электрической изоляции легочных вен. Хотя традиционная радиочастотная абляция (РЧА) остается распространенной, в последние годы широкое внимание привлекла технология однократного холодового воздействия с использованием криобаллонов.Представлен анализ современных подходов к диагностике и криобаллонной абляции при ФП, а также рассмотрены данные, касающиеся применения новых криобаллонных систем. Акцент сделан на сравнении технологий Arctic Front и PolarX, включая различия в компонентах и методах применения. Описаны различные подходы к абляции, включая прямой подход, метод «хоккейная клюшка», метод pull-down и метод pull-away, с фокусом на их клиническую эффективность и снижение риска повреждения диафрагмального нерва.Исследованы ключевые отличия между системами криоабляции, влияющие на клинические исходы. Делается вывод о важности переоценки навыков и практик при внедрении новых технологий, что позволит достичь наибольшей эффективности и безопасности лечения пациентов с ФП. Дальнейшие исследования и постоянное обучение специалистов считаются необходимыми для улучшения результатов лечения и понимания новых технологий в области катетерной абляции.</p></abstract><trans-abstract xml:lang="en"><p>Atrial fibrillation (AF) is one of the most prevalent forms of arrhythmia, affecting approximately 1–2% of the population. Its prevalence is expected to notably increase in the coming decades due to an aging population. AF negatively impacts quality of life and cardiac function, increasing mortality risk. Catheter ablation has become a key method for treating AF, particularly for achieving pulmonary vein isolation (PVI). While traditional radiofrequency ablation remains widespread, recent years have seen increasing attention towards the single-shot cryoballoon ablation technique.This article provides an analysis of contemporary approaches to the diagnosis and cryoballoon ablation of AF, examining data on the application of new cryoballoon systems. Emphasis is placed on comparing Arctic Front and PolarX technologies, including differences in components and application methods. Various ablation approaches are described, including the direct approach, «hockey stick» method, pull-down, and pull-away techniques, focusing on their clinical efficacy and risk reduction of phrenic nerve injury.Key differences between cryoablation systems that influence clinical outcomes are investigated. The article concludes on the importance of re-evaluating skills and practices when introducing new technologies, to achieve the highest efficiency and safety in treating AF patients. Further research and continuous professional development are deemed essential for improving treatment outcomes and understanding new catheter ablation technologies.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>фибрилляция предсердий</kwd><kwd>катетерная абляция</kwd><kwd>криобаллонная абляция</kwd></kwd-group><kwd-group xml:lang="en"><kwd>atrial fibrillation</kwd><kwd>catheter ablation</kwd><kwd>cryoballoon ablation</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Kirchhof P, Benussi S, Kotecha D, Ahlsson A, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. 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