Monatsschrift Kinderheilkunde

, Volume 158, Issue 10, pp 938–945 | Cite as

Pädiatrische Rhythmusstörungen

Aktuelle Diagnostik und Therapie
Leitthema

Zusammenfassung

Die Diagnostik und Therapie von Herzrhythmusstörungen entwickelten sich in den letzten 30 Jahren zu einem wichtigen Spezialgebiet innerhalb der Kinderkardiologie. Limitierte Möglichkeiten einer medikamentösen Behandlung und antibradykarden Herzschrittmachertherapie wurden durch entscheidende Weiterentwicklungen ergänzt. Die überwiegende Zahl der tachykarden Herzrhythmusstörungen lässt sich heute mittels Katheterablation kurativ behandeln. Die primäre und sekundäre Prävention des plötzlichen arrhythmischen Herztodes sind durch implantierbare Defibrillatoren möglich. Eine breite Palette erblicher lebensbedrohlicher Arrhythmiesyndrome wurde entdeckt und gibt einen faszinierenden Einblick in den molekulargenetischen Hintergrund der Arrhythmogenese. Die kardiale Resynchronisationstherapie entwickelte sich zu einer der wenigen kausalen Behandlungsstrategien beim Herzversagen und bietet Einblick in die Remodellingprozesse auf zellulärer Ebene. Im vorliegenden Beitrag wird in einem praxisbezogenen und mit Hintergrundwissen unterstützten Text auf einige der genannten Neuerungen eingegangen.

Schlüsselwörter

Herzrhythmusstörung Supraventrikuläre Tachykardie Genetische Arrhythmiesyndrome Herzversagen Plötzlicher Herztod 

Pediatric dysrhythmia

Update on diagnosis and therapy

Abstract

Diagnosis and therapy of cardiac dysrhythmia has become an important subspecialization in pediatric cardiology. The limited possibilities of antiarrhythmic drug therapy and antibradycardia pacing have been expanded by completely new and fascinating developments over the last 30 years. Curative treatment for the majority of tachyarrhythmias has been achieved by catheter ablation. Secondary as well as primary prevention of sudden arrhythmic death has become possible thanks to implantable defibrillators. Multiple hereditary life-threatening arrhythmia syndromes have been discovered and give a fascinating insight into the molecular genetic background of arrhythmogenesis. Cardiac resynchronization therapy has evolved into one of the few causal treatment strategies for heart failure and points toward intriguing remodeling processes at the cellular level. The following article provides practical as well as background knowledge of some of these developments.

Keywords

Cardiac dysrhythmia Tachycardia, supraventricular Arrhythmia, genetic Heart failure Death, sudden 

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  1. 1.Kardiocentrum and Cardiovascular Research CentreUniversity Hospital MotolPrahaTschechische Republik
  2. 2.Klinik für Kinderkardiologie, HerzzentrumUniversität LeipzigLeipzigDeutschland

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