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Weltweite Erfahrungen mit automatisierten externen Defibrillatoren

Was haben wir erreicht, was können wir noch erwarten?

Worldwide experience with automated external defibrillators

What have we achieved? What else can we expect?

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Herzschrittmachertherapie + Elektrophysiologie Aims and scope Submit manuscript

Zusammenfassung

Einleitung

In Deutschland versterben jährlich etwa 70.000–100.000 Menschen an einem plötzlichen Herztod (PHT). Der PHT ist nicht durch einzelne Faktoren bedingt, sondern als multifaktorielles Geschehen zu verstehen. In etwa 50 % der Fälle ist der PHT die Erstmanifestation einer Herzkrankheit. Der PHT wird in etwa 90 % der Fälle durch ventrikuläre Tachyarrhythmien hervorgerufen, während bradykarde Rhythmusstörungen nur in etwa 5–10 % der Fälle zum PHT führen.

Methoden

Eine sichere Risikoidentifikation von Patienten, die hinsichtlich eines PHT gefährdet sind, ist bisher nicht gelungen. Die schnelle Defibrillation ist die beste Maßnahme, Kammerflimmern zu terminieren. Deshalb ist die Verfügbarkeit automatisierter externer Defibrillatoren (AED) unerlässlich an Plätzen mit vielen Menschen. Es ist inzwischen unbestritten, dass die Defibrillation durch Laien mit Hilfe von AED zu einer wesentlichen Verbesserung der Überlebensrate von Patienten mit KF führt.

Schlussfolgerung

Es scheint sinnvoll, neben Maßnahmen zur Kardiokompression auch die Therapie mit dem AED bereits in Schulen, auch bei Kindern und Jugendlichen, vorzustellen und zu trainieren. Die AED-Therapie „zu Hause“ hat sich nicht bewährt und steigert die Überlebensrate nicht.

Abstract

Introduction

In Germany approximately 70,000–100,000 SCD patients die from sudden cardiac death (SCD). SCD is not caused by a single factor but is a multifactorial problem. In 50 % of SCD victims, sudden cardiac death is the first manifestation of heart disease. SCD is caused by ventricular tachyarrhythmias in approximately 90 % of patients, whereas SCD is caused by bradyarrhythmias in 5–10 % of the patients.

Methods

Risk stratification is not possible in the majority of them prior to the fatal event. Early defibrillation is the method of choice to terminate ventricular fibrillation. Therefore, it is mandatory to install automatic external defibrillators (AED) in places with many people. There is general agreement that early defibrillation with automated external defibrillators (AED) is an effective tool to treat patients with ventricular fibrillation and will improve survival.

Conclusion

It seems necessary to teach cardiocompression and AED use, also to children and adolescents. AED therapy “at home” did not improve survival in patients with cardiac arrest and can not be recommended.

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  1. Medizinische Klinik II (Schwerpunkte Kardiologie und Angiologie), Marien Hospital Herne, Universitätsklinik der Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Deutschland

    Hans-Joachim Trappe

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Trappe, HJ. Weltweite Erfahrungen mit automatisierten externen Defibrillatoren. Herzschr Elektrophys 27, 31–37 (2016). https://doi.org/10.1007/s00399-016-0414-x

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