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Dtsch Med Wochenschr 2020; 145(08): 543-549
DOI: 10.1055/a-0969-6352
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© Georg Thieme Verlag KG Stuttgart · New York

Vorhofflimmern: Wie wichtig ist der Erhalt des Sinusrhythmus?

Atrial Fibrillation: How Important is Rhythm Control Therapy?
Christian Meyer
,
Andreas Metzner
,
Paulus Kirchhof
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Publication History

Publication Date:
15 April 2020 (online)

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Abstract

Rhythm control therapy, comprising antiarrhythmic drugs, cardioversion, and AF ablation, is an important component in the management of patients with atrial fibrillation (AF). Catheter ablation for AF, mainly targeting isolation of the pulmonary veins (AF ablation), has markedly improved the effectiveness of rhythm control therapy. Rhythm control improves symptoms and quality of life in patients with symptomatic AF. AF ablation maintains sinus rhythm more effectively than antiarrhythmic drug therapy. Antiarrhythmic drugs remain effective after AF ablation, underpinning the synergistic mechanisms of action of AF ablation and antiarrhythmic drugs. Different lifestyle interventions might additionally improve symptoms and rhythm stability in patients with AF. AF ablation appears to improve left ventricular function in a subset of patients. Summarized, rhythm control therapy in patients with symptomatic AF is safe and improves quality of life, including elderly patients with stroke risk factors. Further studies are needed to determine whether rhythm control therapy reduces AF-related complications while improving patient outcome with regard to prognosis.

Auch bei optimaler Frequenzregulierung und effektiver Antikoagulation haben Patienten mit Vorhofflimmern ein erhöhtes Mortalitätsrisiko, sodass die rhythmuserhaltende Therapie derzeit Gegenstand vieler Studien ist. Der vorliegende Beitrag präsentiert hierzu eine aktualisierte Übersicht und fokussiert insbesondere auf die Vorhofflimmerablation.

Schlüsselwörter

Vorhofflimmern - Herzinsuffizienz - Vorhofflimmerablation - rhythmuserhaltende Therapie - Antiarrhythmika

Key words

atrial fibrillation - heart failure - catheter ablation - rhythm control therapy - antiarrhythmic drugs
 

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