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Nachsorge von Patienten nach malignen Arrhythmien

Follow-up of patients after malignant arrhythmias

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Zusammenfassung

Die häufigsten Todesursachen in den Industrienationen sind auf Kammerflimmern zurückzuführen. Entscheidend für das Überleben des Patienten ist einerseits ein rasches und entschiedenes Eingreifen. In der Folge hängt die Prognose von unterschiedlichen, die zerebrale Funktion schützenden Faktoren ab. Neuere Erkenntnisse zielen auf die Vermeidung unnötiger oder sogar schädlicher Maßnahmen während der Reanimation. Darüber hinaus ist bekannt, dass eine qualitativ hochwertige, zeitgerechte Reanimation entscheidend die Prognose beeinflussen kann. Kühlung ist in den letzten Jahren als wichtiger Baustein einer optimalen Versorgung identifiziert worden. Nachdem die akute Phase erfolgreich überstanden wurde, sind sekundär prophylaktische Maßnahmen lebenserhaltend. Insbesondere der antiarrhythmischen Absicherung mittels implantierbarem Defibrillator kommt eine wichtige Funktion zu. Nur im Zusammenspiel der Maßnahmen kann für den Patienten die optimale Therapie erzielt werden.

Abstract

The most common causes of death in industrialized nations are due to ventricular fibrillation. An important factor for survival is a rapid and decisive intervention. Subsequently the prognosis is dependent on various factors with cerebral protective functions. Recent findings target avoidance of unnecessary or even detrimental measures during resuscitation. Furthermore, it is known that a high-quality and timely resuscitation can decisively influence the prognosis. In recent years cooling has been identified as a decisive component of an optimal treatment. Following survival of the acute phase secondary prophylactic measures are necessary to prolong life and the antiarrhythmic safeguard with an implantable defibrillator is of special importance. The optimal therapy for the patient can only achieved by interplay of the measures.

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Literatur

  1. Smith GB, Prytherch DR, Schmidt PE, Featherstone PI (2008) Review and performance evaluation of aggregate weighted ‚track and trigger‘ systems. Resuscitation 77(2):170–179

    Article  PubMed  Google Scholar 

  2. Atwood C, Eisenberg MS, Herlitz J, Rea TD (2005) Incidence of EMS-treated out-of-hospital cardiac arrest in Europe. Resuscitation 67(1):75–80

    Article  PubMed  Google Scholar 

  3. Kuch B, Bolte HD, Hoermann A et al (2002) What is the real hospital mortality from acute myocardial infarction? Epidemiological vs clinical view. Eur Heart J 23(9):714–720

    Article  PubMed  CAS  Google Scholar 

  4. Lowel H, Lewis M, Keil U et al (1995) Temporal trends in myocardial infarct morbidity, mortality and 28-day fatalities and medical management. Results of the Augsburg Myocardial Infarct Register 1985 to 1992. Z Kardiol 84(8):596–605

    PubMed  CAS  Google Scholar 

  5. Spaulding CM, Joly LM, Rosenberg A et al (1997) Immediate coronary angiography in survivors of out-of-hospital cardiac arrest. N Engl J Med 336(23):1629–1633

    Article  PubMed  CAS  Google Scholar 

  6. Myerburg RJ (1986) Epidemiology of ventricular tachycardia/ventricular fibrillation and sudden cardiac death. Pacing Clin Electrophysiol 9(6 Pt 2):1334–1338

    Article  PubMed  CAS  Google Scholar 

  7. Muller D, Agrawal R, Arntz HR (2006) How sudden is sudden cardiac death? Circulation 114(11):1146–1150

    Article  PubMed  Google Scholar 

  8. Moss AJ, Fadl Y, Zareba W et al (2001) Survival benefit with an implanted defibrillator in relation to mortality risk in chronic coronary heart disease. Am J Cardiol 88(5):516–520

    Article  PubMed  CAS  Google Scholar 

  9. Bristow MR, Saxon LA, Boehmer J et al (2004) Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med 350(21):2140–2150

    Article  PubMed  CAS  Google Scholar 

  10. Bardy GH, Lee KL, Mark DB et al (2005) Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med 352(3):225–237

    Article  PubMed  CAS  Google Scholar 

  11. Brugada P, Brugada R, Brugada J (2000) The Brugada syndrome. Curr Cardiol Rep 2(6):507–514

    Article  PubMed  CAS  Google Scholar 

  12. Brugada R, Hong K, Dumaine R et al (2004) Sudden death associated with short-QT syndrome linked to mutations in HERG. Circulation 109(1):30–35

    Article  PubMed  CAS  Google Scholar 

  13. Pitzalis MV, Anaclerio M, Iacoviello M et al (2003) QT-interval prolongation in right precordial leads: an additional electrocardiographic hallmark of Brugada syndrome. J Am Coll Cardiol 42(9):1632–1637

    Article  PubMed  Google Scholar 

  14. Valenzuela TD, Roe DJ, Cretin S et al (1997) Estimating effectiveness of cardiac arrest interventions: a logistic regression survival model. Circulation 96(10):3308–3313

    PubMed  CAS  Google Scholar 

  15. Valenzuela TD, Roe DJ, Nichol G et al (2000) Outcomes of rapid defibrillation by security officers after cardiac arrest in casinos. N Engl J Med 343(17):1206–1209

    Article  PubMed  CAS  Google Scholar 

  16. Muller D, Schnitzer L, Brandt J, Arntz HR (2008) The accuracy of an out-of-hospital 12-lead ECG for the detection of ST-elevation myocardial infarction immediately after resuscitation. Ann Emerg Med 52(6):658–664

    Article  PubMed  Google Scholar 

  17. Brown JP, Mahmud E, Dunford JV, Ben-Yehuda O (2008) Effect of prehospital 12-lead electrocardiogram on activation of the cardiac catheterization laboratory and door-to-balloon time in ST-segment elevation acute myocardial infarction. Am J Cardiol 101(2):158–161

    Article  PubMed  Google Scholar 

  18. Arntz HR, Wenzel V, Dissmann R et al (2008) Out-of-hospital thrombolysis during cardiopulmonary resuscitation in patients with high likelihood of ST-elevation myocardial infarction. Resuscitation 76(2):180–184

    Article  PubMed  Google Scholar 

  19. Sterz F, Holzer M, Roine R et al (2003) Hypothermia after cardiac arrest: a treatment that works. Curr Opin Crit Care 9(3):205–210

    Article  PubMed  Google Scholar 

  20. Safar P, Behringer W, Bottiger BW, Sterz F (2002) Cerebral resuscitation potentials for cardiac arrest. Crit Care Med 30(4 Suppl):S140–S144

    Article  PubMed  Google Scholar 

  21. Harris OA, Colford JM Jr, Good MC, Matz PG (2002) The role of hypothermia in the management of severe brain injury: a meta-analysis. Arch Neurol 59(7):1077–1083

    Article  PubMed  Google Scholar 

  22. Kollmar R, Schabitz WR, Heiland S et al (2002) Neuroprotective effect of delayed moderate hypothermia after focal cerebral ischemia: an MRI study. Stroke 33(7):1899–1904

    Article  PubMed  CAS  Google Scholar 

  23. Castren M, Nordberg P, Svensson L et al (2010) Intra-arrest transnasal evaporative cooling: a randomized, prehospital, multicenter study (PRINCE: Pre-ROSC IntraNasal Cooling Effectiveness). Circulation 122(7):729–736

    Article  PubMed  Google Scholar 

  24. Deakin CD, Nolan JP, Soar J et al (2010) European Resuscitation Council Guidelines for Resuscitation 2010 Section 4. Adult advanced life support. Resuscitation 81(10):1305–1352

    Article  PubMed  Google Scholar 

  25. Bernard SA, Jones BM, Horne MK (1997) Clinical trial of induced hypothermia in comatose survivors of out-of-hospital cardiac arrest. Ann Emerg Med 30(2):146–153

    Article  PubMed  CAS  Google Scholar 

  26. Arrich J (2007) Clinical application of mild therapeutic hypothermia after cardiac arrest. Crit Care Med 35(4):1041–1047

    Article  PubMed  Google Scholar 

  27. Balan IS, Fiskum G, Hazelton J et al (2006) Oximetry-guided reoxygenation improves neurological outcome after experimental cardiac arrest. Stroke 37(12):3008–3013

    Article  PubMed  Google Scholar 

  28. Nolan JP, Laver SR, Welch CA et al (2007) Outcome following admission to UK intensive care units after cardiac arrest: a secondary analysis of the ICNARC Case Mix Programme Database. Anaesthesia 62(12):1207–1216

    Article  PubMed  CAS  Google Scholar 

  29. Koster RW, Baubin MA, Bossaert LL et al (2010) European Resuscitation Council Guidelines for Resuscitation 2010 Section 2. Adult basic life support and use of automated external defibrillators. Resuscitation 81(10):1277–1292

    Article  PubMed  Google Scholar 

  30. Cooley R, Akhtar M, Sra J (1999) Is primary antiarrhythmic drug therapy for ventricular arrhythmias obsolete? Curr Cardiol Rep 1(4):268–273

    Article  PubMed  CAS  Google Scholar 

  31. Klein H, Auricchio A, Reek S, Geller C (1999) New primary prevention trials of sudden cardiac death in patients with left ventricular dysfunction: SCD-HEFT and MADIT-II. Am J Cardiol 83(5B):91D-97D

    Article  PubMed  CAS  Google Scholar 

  32. Block M, Hammel D, Bocker D et al (1996) Drugs or implantable cardioverter-defibrillators in patients with poor left ventricular function? Am J Cardiol 78(5A):62–68

    Article  PubMed  CAS  Google Scholar 

  33. Zipes DP, Camm AJ, Borggrefe M et al (2006) ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death). J Am Coll Cardiol 48(5):e247–e346

    Article  PubMed  Google Scholar 

  34. A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. The Antiarrhythmics versus Implantable Defibrillators (AVID) Investigators (1997) N Engl J Med 337(22):1576–1583

    Google Scholar 

  35. Hohnloser SH, Kuck KH, Dorian P et al (2004) Prophylactic use of an implantable cardioverter-defibrillator after acute myocardial infarction. N Engl J Med 351(24):2481–2488

    Article  PubMed  CAS  Google Scholar 

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  1. Kardiologie/Elektrophysiologie, Herz- und Gefäßzentrum Bad Bevensen, Römstedter Straße 25, 29549, Bad Bevensen, Deutschland

    D. Müller

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Müller, D. Nachsorge von Patienten nach malignen Arrhythmien. Notfall Rettungsmed 14, 104–108 (2011). https://doi.org/10.1007/s10049-010-1387-7

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