Antikoagulation bei chronischem Vorhofflimmern

Zusammenfassung

Bei Patienten mit chronischem Vorhofflimmern ohne systemische Embolien ist eine Langzeitprophylaxe bei gleichzeitiger Herzklappenerkrankung, Kardiomyopathie, Herzwandaneurysma oder intrakardialem Thrombus indiziert. Bei chronischem, nichtrheumatischen Vorhofflimmern ohne Embolien sollte nach den neuesten Untersuchungen (95) auch eine Antikoagulation erfolgen. Bei einem idiopathischen Vorhofflimmern ohne eine Herzerkrankung wird nicht antikoaguliert. Insbesondere bei Kontraindikationen zur oralen Antikoagulation bietet das niedermolekulare Heparin CY 216 eine Alternative zur Behandlung. In einer ersten Untersuchung konnte gezeigt werden, daß bei chronischem Vorhofflimmern ohne eine Embolie durch 1×36 mg CY 216 täglich subkutan über 6 Monate eine Reduktion der Inzidenz von Embolien erreicht wird. Insbesondere bei Patienten mit bereits stattgehabten Embolien scheint diese Prophylaxe wirksam zu sein.

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