Vorhofflimmern – Aktuelle Leitlinien – Therapie in der Praxis und Indikation zur Elektrophysiologie

Vorhofflimmern ist eine der wesentlichen Ursachen für Morbidität und Mortalität vor allem im höheren Lebensalter. Bei den meisten Patienten ist an erster Stelle die Frage der Antikoagulation zu klären. Aus grundsätzlichen Überlegungen heraus wäre es wünschenswert, den Sinusrhythmus zu erhalten bzw. wieder herzustellen. Medikamente sind jedoch leider zum Erhalt des Sinusrhythmus wenig effektiv. Deutlich wirkungsvoller ist die Katheterablation des Vorhofflimmerns. Die Komplexität und die Risiken des Verfahrens erlauben jedoch keinen breiten Einsatz, zumal wesentliche Fragen – wie zum Beispiel die nach der Antikoagulation nach Katheterablation bei Risikopatienten – noch nicht beantwortet sind.

Atrial fibrillation is one of the essential causes of morbidity and mortality especially in patients of advanced age. In most of the patients it is of primary importance to clarify first of all the problem of anticoagulation. Fundamentally, it would be desirable to maintain or re-establish the sinus rhythm. Unfortunately, however, drugs are not very effective in maintaining the sinus rhythm. Catheter ablation of the atrial fibrillation is definitely more effective. This is however a complicated and risky procedure, so that it cannot be done on a large scale, the more so since essential questions are still unanswered, such as anticoagulation after catheter ablation in risk patients.

Key words

atrial fibrillation - anticoagulation - rate control - rhythm control - sinus rhythm - catheter ablation

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1 C = Congestive Heart Failure (Herzinsuffizienz); H = Hypertonie, arterieller Bluthochdruck; A = Alter; D = Diabetes mellitus; S = Schlaganfall

2 Atrial Fibrillation Follow-up Investigation of Rhythm Management

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