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Der Klinikarzt 2011; 40(S 01): 13-17
DOI: 10.1055/s-0031-1292572
Schwerpunkt
© Georg Thieme Verlag Stuttgart · New York

Neue evidenzbasierte Leitlinien – Diagnostik und Therapie des Vorhofflimmerns

New evidence based guidelines to manage atrial fibrillation
Michael Block
1   Klinik für Kardiologie, Klinik Augustinum, München
,
Thomas Budde
2   Klinik für Innere Medizin 1, Alfried Krupp Krankenhaus, Essen
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
04. Oktober 2011 (online)

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Eine große Anzahl von kontrollierten und randomisierten Studien erlaubt es, für die Diagnostik und Therapie von Vorhofflimmern weitestgehend evidenzbasierte Leitlinien herauszugeben. Vor allem die therapeutischen Fortschritte der letzten Jahre hatten zur Folge, dass die Europäische Gesellschaft für Kardiologie (ESC) nach 5 Jahren 2010 ihre Leitlinien überarbeitete. Wesentliche Neuerungen sind weniger strikte Forderungen zur Frequenzkontrolle, eine mehr Patienten betreffende Antikoagulation, beruhend auf dem neuen CHA2DS2-VASc Score, erste Empfehlungen zu neuen fix dosierbaren Antikoagulantien, klare Empfehlungen zur Kombination von Antikoagulantien und Thrombozytenaggregationshemmern bei Koronarstents, die Aufnahme von Dronedaron in die Empfehlungen zur Rhythmusstabilisierung und eine weniger restriktive Empfehlung zur Katheterablation von Vorhofflimmern.

Many controlled and randomized studies allow to write guidelines on the management of patients with atrial fibrillation which are based on solid evidence. Progress made in therapy of atrial fibrillation forced the European Society of Cardiology to update the guidelines after 5 years in 2010. Important changes are less reluctant control of ventricular rate during atrial fibrillation, anticoagulation in more patients based on the CHA2DS2-VASc score, a first mentioning of new antithrombotic agents without need of INR-control, recommendations how to combine anticoagulation with antithrombotic agents in case of coronary stents, incorporation of dronedarone in the recommendations for preventing recurrent atrial fibrillation and a less restrictive recommendation for catheter ablation.

Key words

atrial fibrillation - guidelines - anticoagulation - antiarrhythmic drugs - catheter ablation
 

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