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DOI: 10.1055/s-2005-925579
© Georg Thieme Verlag Stuttgart · New York
Welchen Stellenwert hat die Medikamentöse Therapie?
Der plötzliche HerztodPublication History
Publication Date:
02 January 2006 (online)
![](https://www.thieme-connect.de/media/notfall-hausarztmedizin/200511/lookinside/thumbnails/10.1055-s-2005-925579-1.jpg)
Zusammenfassung
Trotz des gegenüber der ICD-Therapie heutzutage eher gering einzuschätzenden Stellenwerts der medikamentösen Therapie in der Primär- und Sekundärprophylaxe des plötzlichen arrhythmogenen Herztodes ist die flankierende antiarrhythmische Medikation bei ICD-Patienten häufig notwendig und trägt zur Reduktion der Inzidenz symptomatischer ventrikulärer Tachykardien mit Interventionsnotwendigkeit und zur Verbesserung der Lebensqualität bei. Amiodaron gilt hier, neben seiner gesicherten Indikation beim Vorhofflimmern, als immer noch effektivstes Antiarrhythmikum. Der ß-Blocker Therapie bei Patienten mit struktureller Herzerkrankung kommt demgegenüber eine ungebrochene Bedeutung mit signifikanter Verminderung der Gesamtmortalität und insbesondere auch des Risikos des plötzlichen Herztodes zu.
Summary
Despite the present tendency to underestimate the value of drug treatment in the primary and secondary prophylaxis of sudden arrhythmogenic cardiac death, it should be noted that the use of supportive antiarrhythmic medication in ICD recipients is often necessary, and can help to reduce the incidence of symptomatic ventricular tachycardias requiring an intervention, and thus improve the quality of life of the patient. In this respect amiodarone with its proven effect in the treatment of ventricular fibrillation, continues to be the most effective antiarrhythmic agent. Treatment with beta blockers in patients with structural heart disease continues to be of importance, and is associated with a significant reduction in overall mortality, and, in particular, in the risk of sudden cardiac death.
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Anschrift für die Verfasser
Priv.-Doz. Dr. med. Thorsten Lewalter
Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn
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53105 Bonn
Phone: 0228 287-5507
Fax: 0228 287-1598
Email: th.lewalter@uni-bonn.de