Summary
The treatment of atrial fibrillation still remains challenging in everyday practice. Even after the introduction of catheter ablation, the decision-making process about the type of therapy became more complex. The recently published guidelines of the American Heart Association, the American College of Cardiology, and the European Society of Cardiology clearly show therapeutic approaches for different types of atrial fibrillation. The fear of thromboembolism still forces the physician to restore sinus rhythm and achieve optimized anticoagulation. Based on large studies, we are able to decide for each patient individually whether oral anticoagulation or ASA is required. Future studies in a large cohort of patients are still necessary to clarify the value of interventional therapy in conjunction with antiarrhythmic drug therapy. These will provide patients with safe therapy and high quality of life despite presenting paroxysmal or persistent atrial fibrillation.
Zusammenfassung
Die Behandlung der absoluten Arrhythmie bei Vorhofflimmern hat durch die Zunahme der Pulmonalvenenablation und der Häufigkeit an Patienten mit fortgeschrittenem Alter und Herzinsuffizienz an Bedeutung gewonnen. Die Frage, ob im Rahmen von Vorhofflimmern die Rhythmus- oder die Frequenzkontrolle die adäquate Behandlung darstellt, wird besonders vor dem Hintergrund der Daten der AFFIRM- und RACE-Studie kontrovers diskutiert. Die aktuellen Richtlinien der Fachgesellschaften sowie der vorliegende Beiträge zeigen klare Behandlungskonzepte und individuell auf den Patienten zugeschnittene Lösungen. Dementsprechend können die Patienten mit paroxysmalem oder persistierendem Vorhofflimmern ein Leben mit hoher Qualität ohne Angst vor thrombembolischen Ereignissen führen.
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Schwab, J.O., Lüderitz, B. Vorhofflimmern: Frequenz- oder Rhythmuskontrolle—. ZS Kardiologie 94 (Suppl 4), iv49–iv52 (2005). https://doi.org/10.1007/s00392-005-1412-x
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DOI: https://doi.org/10.1007/s00392-005-1412-x
Key words
- Atrial fibrillation
- rate control
- rhythm control
- interventional catheter guided therapy
- anticoagulation
- antiarrhythmic drug therapy