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Herzschrittmachertherapie + Elektrophysiologie

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17.10.2023 | Vorhofflattern | Schwerpunkt

Rechtsatriales isthmusabhängiges Vorhofflattern

Klinischer Verlauf nach Isthmusablation

verfasst von: PD Dr. med. Clemens Jilek, Lukas Gleirscher, Elmar Strzelczyk, Dominik Sepela, Klaus Tiemann, Thorsten Lewalter

Erschienen in: Herzschrittmachertherapie + Elektrophysiologie | Ausgabe 4/2023

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Zusammenfassung

Die Ablation des cavotrikuspidalen Isthmus (CTI) mit Schaffung einer bidirektionalen Isthmusblockade stellt die effektivste Art der Rhythmuskontrolle bei typischem Vorhofflattern dar. Im Vergleich zur medikamentösen Therapie senkt die Ablation die kardiovaskuläre Mortalität, die Gesamtmortalität, das Schlaganfallrisiko sowie das Risiko kardialer Dekompensationen. Vorhofflimmern besteht bei einem hohen Prozentsatz der Patienten nach der Vorhofflatterablation, worauf die Dauer der oralen Antikoagulation unter Berücksichtigung des Schlaganfall- und Blutungsrisikos abzustimmen ist. Ein kombinierter Eingriff von CTI-Ablation und Pulmonalvenenisolation (PVI) bei Patienten mit typischem Vorhofflattern, jedoch ohne Nachweis von Vorhofflimmern, kann individuell bei Patienten älter als 54 Jahre in Abhängigkeit der (kardialen) Komorbiditäten evaluiert werden. Der umfassende diagnostische Blick sollte nicht nur die Arrhythmie, sondern auch eine mögliche koronare Herzkrankheit (KHK) im Auge behalten.

Graphic abstract

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Titel: Rechtsatriales isthmusabhängiges Vorhofflattern
Klinischer Verlauf nach Isthmusablation
verfasst von: PD Dr. med. Clemens Jilek
Lukas Gleirscher
Elmar Strzelczyk
Dominik Sepela
Klaus Tiemann
Thorsten Lewalter
Publikationsdatum: 17.10.2023
Verlag: Springer Medizin
Schlagwörter: Vorhofflattern
Vorhofflimmern
Koronare Herzerkrankung
Kardiale Dekompensation
Erschienen in: Herzschrittmachertherapie + Elektrophysiologie / Ausgabe 4/2023
Print ISSN: 0938-7412
Elektronische ISSN: 1435-1544
DOI: https://doi.org/10.1007/s00399-023-00966-z

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