Zusammenfassung
Die Katheterablation von Kammertachykardien bei Patienten mit und ohne strukturelle Herzerkrankung (SH) ist ein etabliertes Behandlungsverfahren. Bei herzgesunden Patienten verfolgt sie ein kuratives Ziel, bei Patienten mit zugrunde liegender Herzerkrankung wird sie als adjuvantes Verfahren eingesetzt, um häufige ICD-Therapien zu reduzieren und die Prognose zu verbessern. Die Komplikationsrate ist bei Patienten mit SH deutlich höher (6–10 %) als bei Patienten ohne SH (3 %). Lebensbedrohliche Komplikationen wie Tamponade und Schlaganfall sind mit < 1 % selten. Am häufigsten sind vaskuläre Komplikationen. Die prozedurale Mortalität wird mit 0–3 % angegeben.
Abstract
Catheter ablation of ventricular arrhythmias is an established treatment for patients with and without structural heart disease. For patients without structural heart disease, the aim is symptomatic relief, while the ultimate goals for patients with underlying structural heart disease are reduction of ICD therapies and improved prognosis. Rates for major complications range between 6–10 % in patients with structural heart disease. Vascular complications are most common; life-threatening complications (e.g., pericardial tamponade and stroke) are less frequent. Procedure-associated mortality is reported to be 0–3 %. In patients with idiopathic ventricular tachycardia, the complication rate is much lower compared to patients with structural heart disease.
Abbreviations
- ACT:
-
„activated clotting time“
- ARVC:
-
arrhythmogene rechtsventrikuläre Kardiomyopathie
- CS:
-
Koronarsinus
- DCM:
-
dilatative Kardiomyopathie
- F:
-
French
- ICD:
-
implantierbarer Kardioverterdefibrillator
- INR:
-
„international normalized ratio“
- LCA:
-
linke Koronararterie
- NOAK:
-
neue orale Antikoagulantien
- MI:
-
Myokardinfarkt
- RCA:
-
rechte Koronararterie
- SH:
-
strukturelle Herzerkrankung
- VT:
-
ventrikuläre Tachykardie
- VA:
-
ventrikuläre Arrhythmie
- VES:
-
ventrikuläre Extrasystolie
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K. Wasmer und L. Eckardt geben an, dass kein Interessenkonflikt im Zusammenhang mit diesem Artikel besteht.
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Wasmer, K., Eckardt, L. Ablation ventrikulärer Arrhythmien. Herzschr Elektrophys 26, 344–350 (2015). https://doi.org/10.1007/s00399-015-0403-5
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DOI: https://doi.org/10.1007/s00399-015-0403-5