DANISH-Studie – ICD bei Patienten mit nicht ischämischer Kardiomyopathie?

Die DANISH-Studie ist die neueste Publikation, die sich mit der primären Prävention des plötzlichen Herztods bei nicht ischämischer Kardiomyopathie auseinandersetzt. Auf den ersten Blick hat die ICD-Implantation dabei keinen statistisch relevanten Effekt auf die Gesamtsterblichkeit. Im Folgenden sollen Therapie und prophylaktische Möglichkeiten bei der NICMP dargestellt und dieser erste Eindruck dabei relativiert werden.

Kernaussagen

• Ventrikuläre Tachykardie und Kammerflimmern stellen neben dem linksventrikulären Pumpversagen bei einer nicht ischämischen Kardiomyopathie (NICM) die Hauptfaktoren für den plötzlichen Herztod (SCD) dar.

• Die einzige valide Therapie zur Vermeidung des Arrhythmie-getriggerten SCDs ist der implantierbare Kardioverter-Defibrillator (ICD). Dennoch ist die Evidenz zur Primärprophylaxe des SCD bei NICM bisher nicht eindeutig belegt.

• Die DANISH-Studie weist jedoch auf einen eindeutigen Vorteil der ICD-Therapie bei jungen Patienten (< 59 Jahren) hin.

Schlüsselwörter

DANISH - implantierbarer Kardioverter-Defibrillator (ICD) - nicht ischämische Kardiomyopathie (NICM)

• Literatur

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