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Ablation ventrikulärer Arrhythmien

Komplikationen und Notfälle

Catheter ablation of ventricular arrhythmias

Complications and emergency situations

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Herzschrittmachertherapie + Elektrophysiologie Aims and scope Submit manuscript

Zusammenfassung

Die Katheterablation von Kammertachykardien bei Patienten mit und ohne strukturelle Herzerkrankung (SH) ist ein etabliertes Behandlungsverfahren. Bei herzgesunden Patienten verfolgt sie ein kuratives Ziel, bei Patienten mit zugrunde liegender Herzerkrankung wird sie als adjuvantes Verfahren eingesetzt, um häufige ICD-Therapien zu reduzieren und die Prognose zu verbessern. Die Komplikationsrate ist bei Patienten mit SH deutlich höher (6–10 %) als bei Patienten ohne SH (3 %). Lebensbedrohliche Komplikationen wie Tamponade und Schlaganfall sind mit < 1 % selten. Am häufigsten sind vaskuläre Komplikationen. Die prozedurale Mortalität wird mit 0–3 % angegeben.

Abstract

Catheter ablation of ventricular arrhythmias is an established treatment for patients with and without structural heart disease. For patients without structural heart disease, the aim is symptomatic relief, while the ultimate goals for patients with underlying structural heart disease are reduction of ICD therapies and improved prognosis. Rates for major complications range between 6–10 % in patients with structural heart disease. Vascular complications are most common; life-threatening complications (e.g., pericardial tamponade and stroke) are less frequent. Procedure-associated mortality is reported to be 0–3 %. In patients with idiopathic ventricular tachycardia, the complication rate is much lower compared to patients with structural heart disease.

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Abbreviations

ACT:

„activated clotting time“

ARVC:

arrhythmogene rechtsventrikuläre Kardiomyopathie

CS:

Koronarsinus

DCM:

dilatative Kardiomyopathie

F:

French

ICD:

implantierbarer Kardioverterdefibrillator

INR:

„international normalized ratio“

LCA:

linke Koronararterie

NOAK:

neue orale Antikoagulantien

MI:

Myokardinfarkt

RCA:

rechte Koronararterie

SH:

strukturelle Herzerkrankung

VT:

ventrikuläre Tachykardie

VA:

ventrikuläre Arrhythmie

VES:

ventrikuläre Extrasystolie

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Author information

Authors and Affiliations

  1. Division of Clinical and Experimental Electrophysiology, Department of Cardiology and Angiology, University Hospital Münster, Münster, Deutschland

    Kristina Wasmer & Lars Eckardt

  2. Abteilung für Rhythmologie, Department für Kardiologie und Angiologie, Universitätsklinikum Münster (UKM), Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Deutschland

    Kristina Wasmer & Lars Eckardt

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Correspondence to Kristina Wasmer.

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K. Wasmer und L. Eckardt geben an, dass kein Interessenkonflikt im Zusammenhang mit diesem Artikel besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Wasmer, K., Eckardt, L. Ablation ventrikulärer Arrhythmien. Herzschr Elektrophys 26, 344–350 (2015). https://doi.org/10.1007/s00399-015-0403-5

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