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Nervenheilkunde 2022; 41(06): 399-404
DOI: 10.1055/a-1822-1085
Schwerpunkt

Rhythmusmanagement bei Vorhofflimmern

Rhythm management in atrial fibrillation
Andreas Metzner
1   Universitäres Herz- und Gefäßzentrum, Klinik für Kardiologie, Universitätsklinikum Hamburg-Eppendorf
,
Melanie Gunawardene
2   Asklepios Klinik St. Georg, Klinik für Kardiologie und internistische Intensivmedizin, Hamburg
,
Stephan Willems
2   Asklepios Klinik St. Georg, Klinik für Kardiologie und internistische Intensivmedizin, Hamburg
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ZUSAMMENFASSUNG

Vorhofflimmern ist die häufigste Herzrhythmusstörung und ist mit einem erhöhten Risiko für Mortalität, Herzinsuffizienz, Schlaganfälle und Demenz assoziiert. Das therapeutische Management des Vorhofflimmerns hat sich in den letzten Jahren in vielfältiger Hinsicht entscheidend verändert. Die frühzeitige Diagnostik und die Einleitung einer gezielten und individualisierten Therapie spielen hierbei eine große Rolle. Die konsequente Behandlung von Risikofaktoren und Begleiterkrankungen sowie die Prävention thrombembolischer Komplikationen rücken in den Vordergrund. Zudem weisen neuste Studienergebnisse auf eine Prognoseverbesserung durch eine frühe Rhythmuskontrolle hin, welche durch antiarrhythmische Medikation oder eine Katheterablation erreicht werden kann. Im folgenden Artikel wird das Therapiemanagement des Vorhofflimmerns mit Fokus auf rhythmuserhaltende Strategien im Kontext der aktuellen Literatur beleuchtet.

ABSTRACT

Atrial fibrillation (AF) is the most common arrhythmia worldwide and is associated with an increased risk of mortality, heart failure, stroke and dementia. Within the last couple of years, management of AF has decisively changed. In this regard, early detection and establishment of an individualized arrhythmia management guided by integrated pathways play a central role. Assessment and consequent treatment of risk factors and comorbidities as well as stroke prevention are essential elements of current guidelines. Additionally, recent studies indicate that early rhythm control of AF may have prognostic impact. Rhythm control can either be gained by antiarrhythmic drug treatment or performance of catheter ablation. In the following article, the therapeutic management of AF with focus on rhythm control strategies will be discussed in context with the current literature.

Schlüsselwörter

Vorhofflimmern - Schlaganfallprophylaxe - orale Antikoagulation - Katheterablation

Key words

Atrial fibrillation - stroke prophylaxis - oral anticoagulation - catheter ablation


Publikationsverlauf

Artikel online veröffentlicht:
07. Juni 2022

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