Prognose von ventrikulären Extrasystolen

Benigne oder maligne?

Prognostic significance of premature ventricular contractions

Harmless or life-threatening?

Zusammenfassung

Ventrikuläre Extrasystolen (VES) stellen einen häufigen und oftmals zufälligen Befund in der Kardiologie dar. Ohne Vorhandensein einer strukturellen Herzerkrankung ist in der Regel von einer benignen Rhythmusstörung auszugehen. Jedoch sollte bei einer EKG-Morphologie, die nicht auf eine idiopathische VES hindeutet, immer eine weiterführende Diagnostik durchgeführt werden. Oftmals wird in diesem Rahmen erstmals eine strukturelle Herzerkrankung diagnostiziert, die mit dem plötzlichen Herztod assoziiert sein kann. Auch polymorphe VES oder eine hohe VES-Last machen eine weitergehende Diagnostik notwendig. Bei diesen Patienten sollte immer eine Risikostratifizierung erfolgen. Die Behandlung von idiopathischen VES sowie von VES bei struktureller Herzerkrankung umfasst neben der medikamentösen Therapie auch die Option der invasiven Katheterablation.

Abstract

Premature ventricular contractions (PVC) are very common arrhythmias in cardiology. In structural normal hearts they usually represent a benign entity. If the ECG morphology is not consistent with idiopathic PVC, further diagnostic workup should be performed. They can occur due to structural heart disease and may be associated with sudden cardiac death. Polymorphic PVC or a high PVC burden should also always lead to further diagnostics and an individual risk-stratification. Therapeutic options include drug therapy and invasive catheter ablation.

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Correspondence to Shibu Mathew MD.

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S. Mathew, J. Schmitt und H. Bogossian geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Mathew, S., Schmitt, J. & Bogossian, H. Prognose von ventrikulären Extrasystolen. Herzschr Elektrophys (2021). https://doi.org/10.1007/s00399-021-00741-y

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Schlüsselwörter

  • Herzrhythmusstörungen
  • Arrhythmogene rechtsventrikuläre Kardiomyopathie
  • Plötzlicher Herztod
  • Katheterablation
  • Prognose

Keywords

  • Cardiac arrhythmias
  • Arrhythmogenic right venricular cardiomyopathy
  • Sudden cardiac death
  • Catheter ablation
  • Prognosis