Der Internist

, Volume 54, Issue 5, pp 583–595 | Cite as


Aktuelle Empfehlungen zur Diagnostik und Behandlung
CME Zertifizierte Fortbildung


Vorhofflimmern ist bei Weitem die häufigste anhaltende Rhythmusstörung. Gehäuft tritt sie im hohen Alter auf. Patienten mit Vorhofflimmern benötigen fast immer eine Therapie mit oralen Antikoagulanzien und eine frequenzregulierende Behandlung. Zusätzlich sollten weitere kardiovaskuläre Erkrankungen sorgfältig behandelt werden, um die Gefahr kardiovaskulärer Komplikationen des Vorhofflimmerns zu verringern. Die meisten Patienten profitieren von einer frequenzregulierenden Therapie mit Medikamenten, welche die Reizleitung am AV-Knoten verlangsamen. Ziel ist eine Herzfrequenz in Ruhe von 100–110/min. Leiden Patienten unter Vorhofflimmern, ist eine rhythmuserhaltende Therapie mit Antiarrhythmika, Kardioversion oder Katheterablation indiziert. Die Wahl der rhythmuserhaltenden Maßnahme sollte nach Sicherheitserwägungen erfolgen. Ob der Erhalt des Sinusrhythmus jenseits einer Verbesserung von Symptomen die Prognose bei Vorhofflimmern verbessert, ist Gegenstand laufender Studien.


Vorhofflimmern Blutungen Schlaganfall Katheterablation Kardioversion Antiarrhythmika 

Atrial fibrillation

Current recommendations for diagnosis and treatment


Atrial fibrillation (AF) is by far the most common arrhythmia. It occurs more often with increasing age. Patients with AF almost always require oral anticoagulants and a rate-control treatment. In addition, other cardiovascular diseases must also be carefully treated in order to reduce the risks of cardiovascular complications from AF. Most patients profit from rate-control treatment with drugs that slow the conduction of the electrical impulse through the AV node. The aim is a resting heart rate of 100–110/min. If patients suffer from AF whilst on optimal rate control therapy, rhythm-control treatment with antiarrhythmic drugs, cardioversion or catheter ablation is indicated. The choice of the rhythm-control therapy should be made based on safety considerations. Whether achieving sinus rhythm beyond improvement of symptoms improves the prognosis of AF is tested in ongoing trials.


Atrial fibrillation Hemorrhage Stroke Catheter ablation Cardioversion Antiarrhythmic drugs 


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Institute for Biomedical ResearchUniversity of Birmingham Centre for Cardiovascular Sciences and SWBH NHS TrustBirminghamUnited Kingdom
  2. 2.Universitätsklinikum MünsterMünsterDeutschland
  3. 3.Kompetenznetz VorhofflimmernMünsterDeutschland

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