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Implantierbare Loop-Rekorder bei Vorhofflimmern und nach Katheterablation

Implantable loop recorder in atrial fibrillation and after catheter ablation

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Zusammenfassung

Hintergrund

Implantierbare Ereignisrekorder (ILR) sind ein etabliertes diagnostisches Verfahren zur Detektion von Herzrhythmusstörungen einschließlich Vorhofflimmern.

Ziel

Das Ziel der vorliegenden Arbeit ist ein Überblick über die Datenlage und Indikationen von ILR bei Vorhofflimmern, insbesondere nach Katheterablation, um praxisrelevante Handlungsempfehlungen zu verdeutlichen.

Material und Methoden

Es erfolgte eine selektive PubMed-Literaturrecherche.

Ergebnisse und Diskussion

ILR können asymptomatische/seltene Vorhofflimmerepisoden aufzeichnen und durch rechtzeitige Einleitung einer oralen Antikoagulation thrombembolische Ereignisse vermeiden. Sie können zur Beurteilung des Therapieerfolgs nach perkutaner oder chirurgischer Ablation eingesetzt werden, wenn trotz erhöhtem thrombembolischem Risiko keine orale Antikoagulation gewünscht ist. Geräte mit Remote-Monitoring-Funktion und speziellen p-Wellen-Detektionsalgorithmen verbessern möglicherweise die diagnostische Sicherheit.

Abstract

Background

Implantable loop recorders (ILR) are an established diagnostic method for detection of cardiac arrhythmias including atrial fibrillation.

Objective

The aim of this work is to provide an overview of available data and indications of ILR in atrial fibrillation, especially after catheter ablation, in order to illustrate practice-oriented recommendations.

Materials and methods

We conducted a selective PubMed literature search.

Results and Discussion

ILR can record asymptomatic/rare atrial fibrillation episodes and prevent thromboembolic events by allowing timely initiation of oral anticoagulation. They can be used to assess therapeutic success after percutaneous or surgical ablation, if despite increased thromboembolic risk, no oral anticoagulation is desired. ILR equipped with remote monitoring function and special P wave detection algorithms may improve diagnostic confidence.

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Authors and Affiliations

  1. Abt. für Rhythmologie, Herzzentrum Leipzig-Universitätsklinik, Klinik für Innere Medizin/Kardiologie, Strümpellstr. 39, 04289, Leipzig, Deutschland

    K. Fikenzer, N. Dagres & G. Hindricks

Authors
  1. K. Fikenzer
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  2. N. Dagres
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  3. G. Hindricks
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Corresponding author

Correspondence to K. Fikenzer.

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Interessenkonflikt

G. Hindricks gibt an, dass die Abteilung für Rhythmologie der Universität Leipzig/Herzzentrum Forschungs- und Studiengelder von Biotronik, St Jude Medical und Boston Scientific erhalten hat. K. Fikenzer und N. Dagres geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Tieren. G. Hindricks war Investigator der XPECT-Studie.

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Fikenzer, K., Dagres, N. & Hindricks, G. Implantierbare Loop-Rekorder bei Vorhofflimmern und nach Katheterablation. Herzschr Elektrophys 27, 355–359 (2016). https://doi.org/10.1007/s00399-016-0471-1

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  • DOI: https://doi.org/10.1007/s00399-016-0471-1

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