Skip to main content
SpringerLink
Log in

Pulmonalvenenisolation mit multipolaren Ablationskathetern zur Behandlung von paroxysmalem Vorhofflimmern

Pulmonary vein isolation with multipolar ablation catheters for the treatment of paroxysmal atrial fibrillation

  • Schwerpunkt
  • Published:
Herzschrittmachertherapie + Elektrophysiologie Aims and scope Submit manuscript

Zusammenfassung

Vorhofflimmern ist die häufigste supraventrikuläre Rhythmusstörung. Sie ist mit einer erhöhten Morbidität und Mortalität verbunden. Verschiedene Therapieoptionen stehen zur Auswahl. Neben der alleinigen Frequenzregularisierung mit begleitender Antikoagulation steht die Rhythmuskontrolle im Fokus der Betrachtung. War bei Patienten mit paroxysmalem Vorhofflimmern bisher die antiarrhythmische Therapie Mittel der Wahl, gewinnt zunehmend die kathetergesteuerte Pulmonalvenenisolation an Bedeutung. Bisherige Verfahren mit „Single Tipp“, Ultraschall oder Kryoballonkathetern werden neuerdings bereichert durch multipolare Radiofrequenzablationskatheter. Sie zeigen im Vergleich ähnlich gute oder bessere Ergebnisse bei geringerer Komplikationsrate und Durchleuchtungszeit.

Abstract

Atrial fibrillation (AFIB) is the most common atrial rhythm disease and is associated with an increased risk of thrombembolic and cardiac complications. Different therapies are used in clinical routine: frequency control with anticoagulants and rhythm control. In patients with paroxysmal AFIB but without structural heart disease, antiarrhythmic drug therapy was previously first priority; however, pulmonary vein catheter ablation is becoming more important. “Single tip” systems, ultrasound, and various balloon techniques have been used in clinical routine. New radiofrequency systems with multipolar radiofrequency ablation catheters, however, give hope for better outcomes with fewer intraprocedural complications, as well as shorter procedure and fluoroscopy times.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5
Abb. 6
Abb. 7
Abb. 8
Abb. 9
Abb. 10
Abb. 11
Abb. 12
Abb. 13

Literatur

  1. Boersma LV et al (2008) Clinical efficacy OF PV antrum ablation for AF by duty-cycled RF energy through a novel circumlinear decapolar catheter. Heart Rhythm (Suppl 5)

  2. Boersma LV, Wijffels MC, Oral H et al (2008) Pulmonary vein isolation by duty-cycled bipolar and unipolar radiofrequency energy with a multielectrode ablation catheter. Heart Rhythm 5:1635–1642

    Article  PubMed  Google Scholar 

  3. De Filippo, He DS, Brambilla R et al (2009) Clinical experience with a single catheter for mapping and ablation of pulmonary vein ostium. J Cardiovasc Electrophysiol 20(4):367–373

    Article  Google Scholar 

  4. Haissaguerre M, Jais P, Shah DC et al (1998) Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med 339:659–666

    Article  CAS  PubMed  Google Scholar 

  5. Kirchhof P, Auricchio A, Bax J et al (2007) Outcome parameters for trials in atrial fibrillation: executive summary: Recommendations from a consensus conference organized by the German Atrial Fibrillation Competence NETwork (AFNET) and the European Heart Rhythm Association (EHRA). Eur Heart J 28(22):2803–2817

    Article  PubMed  Google Scholar 

  6. Kirchhof P, Breithardt G et al (2008) Vorhofflimmern – eine Standortbestimmung. Vorkommen, Mechanismen und klinische Präsentation. Klinikarzt 37(2):66–70

    Article  Google Scholar 

  7. Lewalter T, Williams C Likfett L et al (2008) Combined mapping and ablation with a high density mesh electrode catheter for atrial fibrillation: Acute catheter performance from a german and austrian multicenter evaluation. R.C. BARD Company

  8. Meissner A, Plehn G, Van Bracht M et al (2009) First experiences for pulmonary vein isolation with the high-density mesh ablator (HDMA): a novel mesh electrode catheter for both mapping and radiofrequency delivery in a single unit. J Cardiovasc Electrophysiol 20(4):359–366

    Article  PubMed  Google Scholar 

  9. Murray S (2008) Techniques for left common pulmonary vein isolation using PVAC: Insights from two cases of left common ostia. http://www.ablationfrontiers.com/webdocuments/ablation-frontiers-case-report-1.pdf

  10. Pappone C, Rosanio S, Oreto G et al (2000) Circumferential radiofrequency ablation of pulmonary vein ostia: a new anatomic approach for curing atrial fibrillation. Circulation 102:2619–2628

    CAS  PubMed  Google Scholar 

  11. Pratola, Notarstefano P, Artale P et al (2008) Paroxysmal atrial fibrillation ablation with the multipolar mapping and ablation catheter (Mesh-Bard). Pacing Clin Electrophysiol 31:753–756

    Article  PubMed  Google Scholar 

  12. Singh BN, Singh SN, Reda DJ et al (2005) For the sotalol amiodarone atrial fibrillation efficacy trial (SAFE-T) Investugators: Amiodarone verus sotalol for atrial fibrillation. N Engl J Med 352:1861–1872

    Article  CAS  PubMed  Google Scholar 

  13. Steinwender C, Hönig S, Leisch F, Hofmann R (2009) Acute results of pulmonary vein isolation in patients with paroxysmal atrial fibrillation using a single mesh catheter. J Cardiovasc Electrophysiol 20(2):147–152

    Article  PubMed  Google Scholar 

  14. Weber S, Fredersdorf S, Jilek C et al (2008) Isolation of pulmonary veins using a novel decapolar catheter for mapping and ablation. Circulation 118:S_925

    Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

  1. Abt. III Kardiologie, St. Vincentius Kliniken Karlsruhe, Karlsruhe, Deutschland

    H. Bauerle, T. Japha & B.-D. Gonska

Authors
  1. H. Bauerle
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T. Japha
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B.-D. Gonska
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to H. Bauerle.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bauerle, H., Japha, T. & Gonska, BD. Pulmonalvenenisolation mit multipolaren Ablationskathetern zur Behandlung von paroxysmalem Vorhofflimmern. Herzschr. Elektrophys. 20, 82–89 (2009). https://doi.org/10.1007/s00399-009-0044-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00399-009-0044-7

Schlüsselworte

Keywords

Search

Navigation