Moderne Konzepte in der Diagnostik und Therapie von Herzrhythmusstörungen

Zusammenfassung

Die Diagnostik und Therapie von Herzrhythmusstörungen im Kindesalter hat sich in den letzten 30 Jahren grundlegend geändert. Limitierte Möglichkeiten einer medikamentösen Behandlung und antibradykarden Herzschrittmachertherapie wurden durch erhebliche Weiterentwicklungen ergänzt. Die wichtigsten Neuerungen bestehen in: 1. der Möglichkeit einer kurativen Therapie der überwiegenden Zahl von tachykarden Herzrhythmusstörungen durch Katheterablation, 2. entscheidenden Fortschritten in der Primär- und Sekundärprävention des plötzli-chen arrhythmischen Herztodes durch implantierbare Defibrillatoren, 3. der Möglichkeit, dyssynchrones Herzversagen durch die kardiale Resynchronisationstherapie effektiv zu behandeln und 4. der Entdeckung einer ganzen Palette von genetisch bedingten lebensbedrohlichen Arrhythmien. Im folgenden Text wollen wir uns zwei Aspekten dieser breiten Problematik widmen, und zwar der häufigsten behandlungsbedürftigen Rhythmusstörung im Kindesalter, der paroxysmalen supraventrikulären Tachykardie und dem fasziniernden Neuland der genetischen Arrhythmien.

Summary

The diagnosis and therapy of cardiac dysrhythmias in children has remarkably changed over the last 30 years. Limited possibilites of antiarrhythmic drug therapy and antibrady -cardia pacing were replaced by fascinating new developments including: 1. curative therapy of the majority of tachyarrhythmias by catheter ablation, 2. major advances in the primary und secondary prevention of sudden ar-rhythmic death by implantable defibrillators, 3. the possibility of heart failure treatment by cardiac resynchronization therapy and 4. discovery of a whole range of life-threatening genetic arrhythmias. The following text will focus on two major aspects of pediatric rhythmology: paroxysmal supraventricular tachy -cardias and the fascinating new land of genetic arrhythmias.

Schlüsselwörter

Herzrhythmusstörung - supraventrikuläre Tachykardie - genetische Arrhythmien

Keywords

Dysrhythmias - supraventricular tachycardia - genetic arrhythmias

• Literatur

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