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Katheterablation von isthmusabhängigem Vorhofflattern

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Zusammenfassung

Vorhofflattern ist eine der häufigsten supraventrikulären Rhythmusstörungen und tritt mit einer Inzidenz von 88/100.000 auf. Es besteht ein ähnlich hohes Thrombembolierisiko wie bei Vorhofflimmern und zusätzlich das Risiko einer 1:1 Überleitung auf die Ventrikel. Da die medikamentöse Dauertherapie keinen signifikanten Erfolg bringt, stellt die kathetergesteuerte Ablation von isthmusabhängigem Vorhofflattern eine Wirksame Alternative dar. Seit der Erstbeschreibung einer Radiofrequenzablation bis heute, konnte das Verfahren soweit verbessert werden, dass eine Erfolgsrate von 90-96% bei einer Rezidivrate von 2-6% erreicht wird. Die Komplikationen, wie ein AV-Block oder ein Perikarderguss, sind mit 2% relativ selten. Moderne Ablationstechniken wie z.B. das Kryoverfahren zeigen ähnliche Erfolgszahlen und stellen in Zukunft eine Alternative zur Radiofrequenzbehandlung dar.

Abstract

Atrial flutter is one of the most common supraventricular arrhythmic diseases and occurs with an incidence of 88/100,000. The high risk for thrombembolic events is similar to that for atrial fibrillation and also has the risk for fast conduction to the ventricle. Pharmacological treatment is not significantly effective. Catheter ablation of common atrial flutter offers an alternative with a high quality outcome ranging from 90-96% and a low recurrence rate of 2-6%. Radiofrequency catheter ablation of the cavotricuspidal isthmus is an established treatment for common atrial flutter. Modern techniques like cryo-ablation show nearly the same results and will be an alternative to the RF ablation in the future.

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Authors and Affiliations

  1. Abt. III, Kardiologie, St. Vincentius Kliniken Karlsruhe Akad. Lehrkrankenhaus Universität Freiburg , Sűdendstrasse 32, 76137, Karlsruhe, Germany

    Hansjörg Bauerle

  2. Med. Klinik, Abt. III, St. Vincentius Kliniken, Karlsruhe, Akad. Lehrkrankenhaus Universität Freiburg, Südendstraße 32, 76137, Karlsruhe, Germany

    T. Japha & B. -D. Gonska

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Bauerle, H., Japha, T. & Gonska, B.D. Katheterablation von isthmusabhängigem Vorhofflattern. Herzschr. Elektrophys. 19, 60–67 (2008). https://doi.org/10.1007/s00399-008-0001-x

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