Katheterablation des Vorhofflimmerns - wo stehen wir 2008?

Abstract

Atrial fibrillation is the most common atrial arrhythmia with a prevalence of 0,5 - 1 % in the general population. The presence of atrial fibrillation is associated with an increased mortality and reduced quality of life. Due to a limited efficacy of the current available medical treatment, catheter ablation of atrial fibrillation has gained growing popularity as an effective and possible curative treatment. It is general accepted that focal activity in the pulmonary veins are playing an important role in the pathophysiology of paroxysmal atrial fibrillation and therefore a complete isolation of all pulmonary veins is the basis of a successful catheter ablation. On the other hand discussion about the optimal ablation strategy in persistent atrial fibrillation is still ongoing.

Kernaussagen

• Im Gegensatz zu einer häufig frustranen medikamentösen Therapie verspricht die Ablation des Vorhofflimmerns einen kurativen Behandlungsansatz.

• Insbesondere für die Behandlung des paroxysmalen Vorhofflimmerns existieren reproduzierbare Daten und ein weitgehend einheitliches Behandlungskonzept.

• Die Selektion bzw. Indikationsstellung für dieses Behandlungsverfahren ist aufgrund der Komplexität kritisch zu bewerten. Bevorzugt sollten symptomatische Patienten mit paroxysmalem Vorhofflimmern in Betracht gezogen werden.

• Eine abschließende Beurteilung über die optimale Ablationsmethode des persistierenden Vorhofflimmerns ist derzeit nicht möglich.

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