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Notfallmanagement supraventrikulärer regelmäßiger Tachykardien

Emergency management of regular supraventricular tachycardias

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Zusammenfassung

Mit einer geschätzten Inzidenz von ca. 36/100.000 Einwohnern und Jahr stellen paroxysmale supraventrikuläre Tachykardien eine relevante klinische Problematik dar. Sie treten auf Basis unterschiedlicher Substrate ein, und ihre Klinik sowie elektrokardiographische Präsentation sind vielgestaltig. Das 12-Kanal-Oberflächen-EKG bildet die Grundlage der differenzialdiagnostischen Bestimmung des zugrundeliegenden Pathomechanismus. Daran können erregungsbildende und erregungsleitende Strukturen sowie das atriale Myokard selbst beteiligt sein. Zur Akutbehandlung stehen neben vagomimetischen Manövern überwiegend differenzierte pharmakologische Strategien bis hin zur Ablation zur Verfügung.

Abstract

With an estimated incidence of approximated 36 per 100,000 persons per year, paroxysmal supraventricular tachycardias form a relevant clinical set of problems. They occur based on different substrates with varied symptoms and electrocardiographic items. The 12-channel ECG depicts the background to determine the underlying pathomechanism. The sinus node and all components of the conduction system such as atrial myocardium can be involved. Vagal maneuvers, several pharmacological strategies and various ablation technology are available for acute therapy.

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Abbreviations

AVNRT:

AV-nodale Reentry-Tachykardie

AVRT:

Atrioventrikuläre Reentry-Tachykardie

BWA:

Brustwandableitungen

FAT:

Fokale atriale Tachykardie

IST:

Inadäquate Sinusknotentachykardie

ICD:

Implantierbarer Kardioverter/Defibrillator

LBBB:

Linksschenkelblock

MAT:

Multifokale atriale Tachykardie

PJRT:

Permanente junktionale Reentry-Tachykardie

RBBB:

Rechtsschenkelblock

RLS:

Reizleitungssystem

SVT:

Supraventrikuläre Tachykardie

TEE:

Transösophageale Echokardiographie

VT:

Ventrikuläre Tachykardie

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Authors and Affiliations

  1. I. Medizinische Klinik – Kardiologie/Elektrophysiologie, St. Agnes-Hospital Bocholt, Klinikum Westmünsterland, Barloer Weg 125, 46397, Bocholt, Deutschland

    R. Höltgen &  M. Wieczorek

  2. Medizinische Fakultät, Semmelweis Universität, Campus Hamburg, Lohmühlenstraße 5/Haus P, 20099, Hamburg, Deutschland

    D. Bandorski

  3. Neurologische Klinik Bad Salzhausen, Intensivmedizin und internistische Diagnostik, Am Hasensprung 6, 63667, Nidda, Deutschland

    D. Bandorski

  4. Abteilung für Kardiologie, Elektrophysiologie und Angiologie, Märkische Kliniken GmbH, Klinikum Lüdenscheid, Paulmannshöher Str. 14, 58515, Lüdenscheid, Deutschland

    H. Bogossian

  5. Universität Witten/Herdecke, Witten, Deutschland

    H. Bogossian &  M. Wieczorek

  6. Medizinische Klinik I, Lahn-Dill-Kliniken – Klinikum Wetzlar, Forsthausstraße 1, 35578, Wetzlar, Deutschland

    M. Brück

Authors
  1. R. Höltgen
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  2. D. Bandorski
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  3. H. Bogossian
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  4. M. Brück
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  5. M. Wieczorek
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Corresponding author

Correspondence to R. Höltgen.

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Interessenkonflikt

R. Höltgen, D. Bandorski, H. Bogossian, M. Brück und M. Wieczorek geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Höltgen, R., Bandorski, D., Bogossian, H. et al. Notfallmanagement supraventrikulärer regelmäßiger Tachykardien. Herzschr Elektrophys 31, 10–19 (2020). https://doi.org/10.1007/s00399-020-00673-z

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  • DOI: https://doi.org/10.1007/s00399-020-00673-z

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