Antiarrhythmische Therapie bei Vorhofflimmern

Zusammenfassung

Vorhofflimmern tritt bei einer Vielzahl kardiologischer Grunderkrankungen auf und führt in vielen Fällen zu beträchtlicher Symptomatik. Die Rhythmusstörung sollte zunächst (nach Einleitung einer oralen Antikoagulation entsprechend Risikoscores) mit einer Medikation zur Kontrolle der Kammerfrequenz behandelt werden. Führt dies nicht zu der erwünschten Besserung der Beschwerden, ist eine Therapie zu Wiederherstellung und Erhalt des Sinusrhythmus indiziert. Kommt es hierunter zu symptomatischen Rezidiven sollte die Indikation zu einer Ablationstherapie geprüft werden.

Abstract

Atrial fibrillation occurs in the context of several cardiac disease entities and may lead to significant symptoms. In general, the arrhythmia should initially (after initiation of an oral anticoagulation according to risk stratification schemes) be treated in an attempt to control ventricular rate. If this does not lead to sufficient relief of symptoms, further medical therapy that aims at restoration and maintenance of sinus rhythm should be applied. If there are still symptomatic relapses with such medication an ablation therapy should be considered.

Schlüsselwörter

Vorhofflimmern - Antiarrhythmika - Rezidivprophylaxe - medikamentöse Kardioversion

Key words

atrial fibrillation - antiarrhythmic drugs - relapse prevention - pharmacological cardioversion

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