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Arrhythmien bei Patienten mit operativ korrigierter Fallot-Tetralogie

Arrhythmias in patients with surgically corrected tetralogy of Fallot

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Herzschrittmachertherapie + Elektrophysiologie Aims and scope Submit manuscript

Zusammenfassung

Die Fallot-Tetralogie (FT) ist eine der häufigsten kongenitalen Herzerkrankungen des Erwachsenenalters. Bei betroffenen Patienten treten sowohl atriale als auch ventrikuläre Arrhythmien auf, die einer kritischen Prüfung therapeutischer Maßnahmen unter Berücksichtigung einer ICD-Implantation und einer Katheterablation bedürfen. Die komplexe Anatomie, Myokardhypertrophie, breite Isthmi und Erregungsausbreitungsstörungen stellen eine besondere Herausforderung im Hinblick auf die Risikostratifizierung sowie eine mögliche Ablationsstrategie bei betroffenen Patienten dar. Ziel der vorliegenden Arbeit ist es 1. eine Übersicht über typische Arrhythmien zu geben, mit denen im klinischen Alltag im Umgang mit Fallot-Patienten zu rechnen ist und 2. therapeutische Möglichkeiten zur Behandlung von Tachyarrhythmien unter besonderer Berücksichtigung der Katheterablation zu beleuchten.

Abstract

The population of adults with surgically corrected tetralogy of Fallot (TOF) is increasing. Atrial and ventricular arrhythmias are prevalent, and therapeutical approaches including implantable cardioverter-defibrillators and radiofrequency catheter ablation need to be considered carefully for the prevention of hemodynamic deterioration and sudden cardiac death. Complex anatomy, myocardial hypertrophy, and broad channels of slow conduction may in part explain some challenges regarding risk stratification, and identification/modification of the arrhythmogenic substrate in these patients. The aim of this brief review is 2-fold: (1.) To present insights into characteristics of typical TOF related arrhythmias and (2.) to reflect therapeutical concepts targeting tachyarrhythmias in these patients by focusing on catheter ablation.

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Authors and Affiliations

  1. Abteilung für Innere Medizin II/Kardiologie, Krankenhaus der Elisabethinen, Linz, Österreich

    C. Meyer MA, M. Martinek, S. Winter, H.-J. Nesser & H. Pürerfellner

  2. Klinik für Kardiologie, Pneumologie und Angiologie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland

    C. Meyer MA

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  1. C. Meyer MA
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  2. M. Martinek
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  3. S. Winter
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  4. H.-J. Nesser
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  5. H. Pürerfellner
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Correspondence to C. Meyer MA.

Additional information

CM erhält Unterstützung von der European Heart Rhythm Association (EHRA) im Rahmen des „Fellowship (Advanced Program) in Interventional Electrophysiology“.

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Meyer, C., Martinek, M., Winter, S. et al. Arrhythmien bei Patienten mit operativ korrigierter Fallot-Tetralogie. Herzschr. Elektrophys. 21, 189–195 (2010). https://doi.org/10.1007/s00399-010-0103-0

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  • DOI: https://doi.org/10.1007/s00399-010-0103-0

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