Typisches und atypisches Vorhofflattern

Abstract

Atrial flutter is a common arrhythmia. It is a macroreentry tachycardia encircling the tricuspid valve (common type) or other structures (uncommon type). Due to a limited efficacy of the current available medical treatment, catheter ablation of atrial flutter has gained growing importance as an effective and possible curative treatment. Whereas the ablation of common type atrial flutter is well established and nowadays routine in every EP lab, the ablation of uncommon type atrial flutter is still challenging.

Kernaussagen

• Typisches Vorhofflattern kreist immer um die Trikuspidalklappe. Mit der Ablation des kavotrikuspidalen Isthmus steht eine seit Langem etablierte und sichere Behandlungsmethode zur Verfügung, die auch im Sinusrhythmus durchgeführt werden kann.

• Atypisches Vorhofflattern kreist nicht um die Trikuspidalklappe. Es ist oft schwierig, den genauen Erregungskreislauf im 12-Kanal-EKG diagnostizieren zu können.

• Die Katheterablation des atypischen Vorhofflatterns ist eine Erfolg versprechende Behandlungsmethode. Aufgrund ihrer Komplexität sollte sie aber nur in erfahrenen Zentren nach kritischer Indikationsstellung durchgeführt werden.

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