Resynchronisationsbehandlung bei Herzinsuffizienz – Wann und für wen?

Die meisten Patienten mit Herzinsuffizienz bleiben auch heute noch symptomatisch, trotz aller Fortschritte in der medikamentösen Behandlung. Einem Teil dieser Patienten kann mit einer Resynchronisationsbehandlung geholfen werden. Nach aktueller Studienlage kann bei Patienten mit systolischer Herzinsuffizienz und der Indikation für eine permanente Ventrikelstimulation sowie bei Patienten mit reduzierter Ejektionsfraktion, breitem QRS-Komplex und Sinusrhythmus eine solche Therapie empfohlen werden. Für Patienten mit Vorhofflimmern liegen noch keine randomisierten Studien vor, jedoch scheint auch hier unter bestimmten Bedingungen eine Resynchronisationstherapie möglich zu sein.

Most of the patients suffering from cardiac insufficiency remain symptomatic in spite of the great progress that has taken place in the sphere of drug treatment. Update studies have shown that resynchronization treatment may help some of these patients, especially those with systolic cardiac insufficiency and an indication for permanent ventricular stimulation. This treatment may also be recommended for patients with reduced ejection fraction, a broad QRS complex and sinus rhythm. No randomized studies are presently available which have been conducted with patients suffering from atrial fibrillation, but it seems that even such patients may be subjected to resynchronization.

Key words

cardiac insufficiency - resynchronization therapy - biventricular pacing

Literatur

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1 CArdiac REsynchronisation in Heart Failure

2 Comparison Of Medical therapy, Pacing ANd defibrillatION in chronic Heart Failure

3 Predictors of Response to CRT

4 Resynchronisation therapy in narrow QRS

5 Multicenter InSync RAndomized CLinical Evaluation

6 REsynchronisation reVErses Remodelling in a Symptomatic left vEntricular dysfunction7 MUltiside STimulation in Cardiomyopathy

7 MUltiside STimulation in Cardiomyopathy

8 Optimal Pacing SITE

9 Post AV nodal ablation Evaluation study

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