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Antikoagulation und Antiarrhythmika nach Vorhofflimmerablation

Anticoagulation and antiarrhythmic drug therapy after catheter ablation of atrial fibrillation

  • Published:
Clinical Research in Cardiology Supplements Aims and scope

Zusammenfassung

Prospektive Untersuchungen zur Gabe von Antikoagulanzien und Antiarrhythmika nach Vorhofflimmerablation liegen bislang nicht vor. Allerdings existieren Expertenempfehlungen aus dem Jahre 2007, die zu Indikation und Dauer einer Antikoagulation sowie zum Einsatz von Antiarrhythmika nach der Ablationsprozedur Stellung nehmen. Eine orale Antikoagulation wird für alle Patienten postinterventionell für mindestens 2 Monate empfohlen. Bei Patienten mit einem CHADS2-Score ≥2 sollte die Antikoagulation generell nicht beendet werden, unabhängig vom Vorhandensein oder Typ des Vorhofflimmerns. Antiarrhythmika können in den ersten 3 Monaten nach Ablation Vorhofflimmerrezidive unterdrücken, die in erster Linie auf postablatorischen inflammatorischen Prozessen beruhen. Auch nach Absetzen der Antiarrhythmika auftretende Arrhythmierezidive lassen sich medikamentös antiarrhythmisch behandeln, da primär wirkungslose Antiarrhythmika nach dem Ablationsversuch durchaus effektiv sein können.

Abstract

There are still no prospective studies concerning the use of anticoagulants and antiarrhythmic drugs after catheter ablation of atrial fibrillation. However, since 2007 experts have been stating recommendations for the indication and duration of anticoagulation as well as for the use of antiarrhythmic drugs after the ablation procedure. Postinterventionally oral anticoagulation is recommended for all patients for at least 2 months. Anticoagulation should continue in all patients who have a CHADS2 score ≥2, the type or persistence of atrial fibrillation then is not important. For the first 3 months antiarrhythmic drugs can successfully suppress relapses of atrial fibrillation which are caused by post-interventional tissue inflammation. In case of a relapse of atrial fibrillation antiarrhythmic drugs, which were initially ineffective, could be used successfully after the catheter ablation.

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Authors and Affiliations

  1. Ärztlicher Direktor, Erzgebirgsklinikum Annaberg, Klinik für Innere Medizin/Kardiologie, Chemnitzer Straße 15, 09456, Annaberg-Buchholz, Germany

    H. Volkmann

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  1. H. Volkmann
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  2. C. Bergmann
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  3. M. Walter
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Correspondence to H. Volkmann.

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Volkmann, H., Bergmann, C. & Walter, M. Antikoagulation und Antiarrhythmika nach Vorhofflimmerablation. Clin Res Cardiol Suppl 3, 118–123 (2008). https://doi.org/10.1007/s11789-008-0035-y

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  • DOI: https://doi.org/10.1007/s11789-008-0035-y

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