Tachykarde Rhythmusstörungen bei herzkranken Patienten: Wann sind sie nicht behandlungsbedürftig?
Chapter
Zusammenfassung
Wie auch bei anderen Erkrankungen erübrigt sich die Behandlung von Herzrhythmusstörungen grundsätzlich immer dann, wenn sie nicht gefährlicher einzuschätzen sind als die Therapie selbst und wenn sie keine so schwer wiegenden Symptome verursachen, dass das Therapierisiko gerechtfertigt erscheint. Entsprechend bedarf es der individuellen Abschätzung des Arrhythmierisikos, des Therapierisikos und der klinischen Symptomatik.
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Literatur
- 1.The Antiarrhythmics versus Implantable Defibrillators (AVID) Investigators (1997) A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. N Engl J Med 337: 1576–1583Google Scholar
- 2.Bigger JT Jr (1997) Prophylactic use of implanted cardiac defibrillators in patients at high risk for ventricular arrhythmias after coronary-artery bypass graft surgery. Coronary Artery Bypass Graft (CABG) Patch Trial Investigators. N Engl J Med 337: 1569–1575PubMedCrossRefGoogle Scholar
- 3.Buxton AE, Lee KL, Fisher JD, Josephson ME, Prystowsk EN, Hafley G (1999) A randomized study of the prevention of sudden death in patients with coronary artery disease. Multicenter Unsustained Tachycardia Trial Investigators. N Engl J Med 341: 1882–1890PubMedCrossRefGoogle Scholar
- 4.Campbell RW (1994) What happens to people with `supra’ ventricular tachycardia? Eur Heart J (Suppl A) 15: 27–30Google Scholar
- 5.The Cardiac Arrhythmia Suppression Trial (CAST) Investigators (1989) Preliminary report: effect of encainide and flecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction. N Engl J Med 321: 406–412Google Scholar
- 6.Connolly SJ, Gent M, Roberts RS, Dorian P, Roy D, Sheldon RS, Mitchell LB, Green MS, Klein GJ, O’Brien B (2000) Canadian implantable defibrillator study (CIDS): a randomized trial of the implantable cardioverter defibrillator against amiodarone. Circulation 101: 1297–1302PubMedGoogle Scholar
- 7.Coplen SE, Antman EM, Berlin JA, Hewitt P, Chalmers TC (1990) Efficacy and safety of quinidine therapy for maintenance of sinus rhythm after cardioversion. A meta-analysis of randomized control trials. Circulation 82: 1106–1116PubMedCrossRefGoogle Scholar
- 8.Gold MR, Bloomfield DM, Anderson KP, El-Sherif NE, Wilber DJ, Groh WJ, Estes NA 3rd, Kaufman ES, Greenberg ML, Rosenbaum DS (2000) A comparison of T-wave alternans, signal averaged electrocardiography and programmed ventricular stimulation for arrhythmia risk stratification. J Am Coll Cardiol 36: 2247–2253PubMedCrossRefGoogle Scholar
- 9.Grimm W, Glaveris C, Hoffmann J et al. (2000) Arrhythmia risk stratification in idiopathic dilated cardiomyopathy based on echocardiography and 12-lead, signal-averaged, and 24-hour bolter electrocardiography. Am Heart J 140: 43–51PubMedCrossRefGoogle Scholar
- 10.Knight BP, Goyal R, Pelosi F et al. (1999) Outcome of patients with nonischemic dilated cardiomyopathy and unexplained syncope treated with an implantable defibrillator. J Am Coll Cardiol 33: 1964–1970PubMedCrossRefGoogle Scholar
- 11.Kuck KH (1997) Arrhythmias in hypertrophic cardiomyopathy. Pacing Clin Electrophysiol 20: 2706–2713PubMedCrossRefGoogle Scholar
- 12.Levy S (1992) Arrhythmias in mitral valve prolapse syndrome: clinical significance and management. Pacing Clin Electrophysiol 15: 1080–1088PubMedCrossRefGoogle Scholar
- 13.Meinertz T, Hofmann T, Kasper W et al. (1984) Significance of ventricular arrhythmias in idiopathic dilated cardiomyopathy. Am J Cardiol 53: 902–907PubMedCrossRefGoogle Scholar
- 14.Moss AJ, Hall J, Cannom DS, Daubert JP, Higgins SL, Klein H, Levine JH, Saksena S, Waldo AL, Wilber D, Brown MW, Heo M, for the Multicenter Automatic Defibrillator Implantation Trial Investigators (1996) Improved survival with an implanted defibrillator in patients with coronary artery disease at high risk for ventricular tachycardia. N Engl J Med 335: 1933–1940Google Scholar
- 15.Reimold SC, Chalmers TC, Berlin JA, Antman EM (1992) Assessment of the efficacy and safety of antiarrhythmic therapy for chronic atrial fibrillation: observations on the role of trial design and implications of drug-related mortality. Am Heart J 124: 924–932PubMedCrossRefGoogle Scholar
- 16.Sorgato A, Faggiano P, Aurigemma GP, Rusconi C, Gaasch WH (1998) Ventricular arrhythmias in adult aortic stenosis: prevalence, mechanisms, and clinical relevance. Chest 113: 482–491PubMedCrossRefGoogle Scholar
- 17.Sweeney MO (2001) Sudden death in heart failure associated with reduced left ventricular function: substrates, mechanisms, and evidence-based management, Part I. Pacing Clin Electrophysiol 24: 871–888PubMedCrossRefGoogle Scholar
- 18.Sweeney MO (2001) Sudden death in heart failure associated with reduced left ventricular function: substrates, mechanisms, and evidence-based management, Part II. Pacing Clin Electrophysiol 24: 1002–1022PubMedCrossRefGoogle Scholar
- 19.Waldo AL, Camm AJ, deRuyter H, Friedman PL, MacNeil DJ, Pauls JF, Pitt B, Pratt CM, Schwartz PJ, Veltri EP (1996) Effect of D-sotalol on mortality in patients with left ventricular dysfunction after recent and remote myocardial infarction. The SWORD Investigators. Survival with oral D-sotalol. Lancet 348: 7–12Google Scholar
- 20.Wilber DJ, Olshansky B, Moran JF, Scanlon PJ (1990) Electrophysiological testing and non-sustained ventricular tachycardia. Use and limitations in patients with coronary artery disease and impaired left ventricular function. Circulation 82: 350–358Google Scholar
- 21.Winters SL, Packer DL, Marchlinski FE, Lazzara R, Cannom DS, Breithardt GE, Wilber DA, Camm AJ, Ruskin JN (2001) Consensus statement on indications, guidelines for use, and recommendations for follow-up of implantable cardioverter defibrillators. Pacing Clin Electrophysiol 24: 262–269PubMedCrossRefGoogle Scholar
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