EKG-Diagnostik von Vorhofflimmern

Zusammenfassung

Während ältere Untersuchungen einen kausalen Zusammenhang zwischen Vorhofflimmern (VHF) und Schlaganfällen bei nur 10 bis 15% der Patienten fanden, konnte in neueren Arbeiten mit kontinuierlichem Monitoring eine hö-here Prävalenz von mindestens 23% nachgewiesen werden. Aufgrund der therapeutischen Konsequenzen wird dem EKG-Monitoring zur Detektion von VHF bei Patienten mit erhöhtem thromboembolischen Risiko und bei Patienten mit stattgehabter zerebraler Ischämie ungeklärter Ätiologie eine hohe Bedeutung beigemessen. Auch bei Patienten mit Zei-chen einer demenziellen Entwicklung ist das Rhythmusmonitoring zur Detektion von Vorhofflimmern gerechtfertigt. Patienten mit dem Wunsch oder der Notwendigkeit einer an den Bedarf angepassten Antikoagulation können ebenfalls von kontinuierlichem Rhythmusmonitoring profitieren. Bei der Etablierung kontinuierlicher Monitoring-Technologien wird in Zukunft telemedizinischen Abfrageprozessen eine größere Bedeutung zukommen, um die zeitliche Verzögerung bei der ambulanten Nachsorge zu vermeiden.

Summary

Historical studies have found atrial fibrillation in only 10 to 15% of patients with a history of stroke. More recent studies with continuous ECG monitoring have shown a higher percentage of atrial fibrillation in up to 23% of these patients. Due to the potential therapeutic consequences in case of detection of atrial fibrillation, ECG monitoring has gained importance, especially in patients with an increased thromboembolic risk and in patients with stroke of unknown origin. Also in patients with signs of dementia, rhythm monitoring is justified. Patients with the necessity or desire for „on demand“ anticoagulation can benefit from continuous rhythm monitoring. In the future, telemonitoring will have an increased clinical significance in order to avoid diagnostic delays.

Schlüsselwörter

Vorhofflimmern - stummes Vorhofflimmern - Schlaganfall - Demenz - EKG-Monitoring

Keywords

Atrial fibrillation - silent atrial fibrillation - AF burden - stroke - dementia - ECG monitoring

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