Clinical Research in Cardiology Supplements

, Volume 1, Issue 2, pp 123–132

Behandlung von Patienten mit Vorhofflimmern

Medikamentöse Therapie oder kurative Katheterablation?
CME Weiterbildung · Zertifizierte Fortbildung
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Zusammenfassung

Zu den Behandlungsoptionen von Vorhofflimmern hat sich neben den bekannten medikamentösen Optionen mittlerweile die kurativ intendierte Katheterablation von Vorhofflimmern etabliert. Diese hat in den vergangenen Jahren entscheidende Fortschritte hin zu einem reproduzierbar und effektiven Verfahren gemacht. Über die Bedeutung der Triggerung von Vorhofflimmerepisoden durch schnelle Extrasystolie aus den Ostien der Pulmonalvenen hinaus konnte durch invasive elektrophysiologische Untersuchungen das die PV umgebende Vorhofmyokard in seiner Bedeutung für die Aufrechterhaltung von anhaltendem Vorhofflimmern weiter charakterisiert werden. Erste randomisierte Studien, die die medikamentöse Strategie mit der Katheterablation vergleichen, bestätigen, dass die primäre Katheterablation der medikamentösen Therapie überlegen ist. Vergleichende Langzeitstudien mit dem Endpunkt „Mortalität“ sind in Planung.

Schlüsselwörter

Vorhofflimmern Medikamentöse Therapie Antikoagulation Katheterablation Vorhofmyokard 

Treatment of patients with atrial fibrillation

Pharmacological treatment or curative catheter ablation?

Abstract

Adding to the known therapeutic options to treat atrial fibrillation, primary catheter ablation has established itself as a curatively intended procedure. It has made some important advances in recent years towards becoming a reproducible and effective procedure. Besides the triggering role to induce atrial fibrillation episodes by rapid burst from within the PV, invasive EP studies could also demonstrate the importance of the surrounding atrial myocardium to sustain the atrial fibrillation. Initial randomized trials already demonstrated the superiority of the ablation procedure over antiarrhythmic therapy in specific patient cohorts. Long-term prospective studies with a mortality endpoint are, however, still in the planning phase.

Keywords

Atrial fibrillation Pharmacologic treatment Anticoagulation Catheter ablation Atrial myocardium 

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Copyright information

© Deutsche Gesellschaft für Kardiologie – Herz- und Kreislaufforschung e. V. 2006

Authors and Affiliations

  1. 1.Hanseatisches HerzzentrumHamburgDeutschland
  2. 2.II. Medizinische AbteilungKlinik St. GeorgHamburgDeutschland

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