Zusammenfassung
In Deutschland wurden 1990 im Durchschnitt mehr als 30 Patienten im Monat von Allgemeinärzten oder Internisten wegen supraventrikulärer Tachyarrhythmien behandelt (Lüderitz u. Manz 1992). Die Behandlung dieser Rhythmusstörungen war bis vor kurzem noch die Domäne der medikamentösen Therapie. Häufiges Therapieversagen, proarrhythmische Effekte und die Notwendigkeit jahrzehntelanger Medikamenteneinnahme haben zur Entwicklung alternativer, d. h. nichtmedikamentöser Therapieverfahren geführt. In den 80er Jahren wurden insbesondere rhythmuschirurgische Verfahren als alternative Therapie eingesetzt (Cox et al. 1985, 1987). Seit Mitte der 80er Jahre standen damit zwar in einigen speziellen Zentren kurative operative Verfahren mit guten Ergebnissen zur Verfügung, jedoch geht die Operation am offenen Herzen mit Thorakotomie und Einsatz der Herz-Lungen-Maschine mit einer nicht unerheblichen Belastung der in der Mehrzahl jungen, sonst herzgesunden Patienten einher. Obwohl bereits 1982 das nichtoperative alternative Therapieverfahren der Katheterablation mit Gleichstrom von Gallagher u. Scheinman erstmals klinisch eingesetzt wurde, fand die Methode in den folgenden Jahren wegen teilweise erheblicher Komplikationen keine wesentliche Verbreitung. Bei dem Verfahren wurde über einen perkutan eingeführten Elektrodenkatheter ein Gleichstromschock auf das zu abladierende myokardiale Substrat abgegeben. Den entscheidenden Durchbruch erlangte die Katheterablation erst Anfang der 90er Jahre durch die Einführung von hochfrequentem Wechselstrom in einem Frequenzbereich zwischen 350 und 750 kHz (Radiofrequenzstrom) als Energiequelle und steuerbaren Kathetern.
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Hoffmann, E. (1999). Supraventrikuläre Tachykardien: Pathomechanismen, Diagnostik und Therapie. In: Hoffmann, E., Steinbeck, G. (eds) Interventionelle kardiale Elektrophysiologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-58522-7_2
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