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DOI: 10.1055/s-0042-107377
Therapie ventrikulärer Arrhythmien und Prävention des plötzlichen Herztodes: Kommentar zur neuen ESC-Leitlinie
Treatment of ventricular tachyarrhythmias and prevention of sudden cardiac death: commentary on the 2016 ESC guidelinePublication History
Publication Date:
10 August 2016 (online)
![](https://www.thieme-connect.de/media/dmw/201616/lookinside/thumbnails/1154_10-1055-s-0042-107377-1.jpg)
Zusammenfassung
Die neue ESC Leitlinie gibt einen umfassenden Überblick über den aktuellen Stand der Diagnostik, Behandlung von Kammertachykardien und der Prävention des plötzlichen Herztods. Neuer Schwerpunkt ist an vielen Stellen die genetische Diagnostik. Darüber hinaus sind vor allem Indikationen zur ICD Therapie, zur Katheterablation und zu hereditären Erkrankungen neu bewertet worden. Publizierte Registerdaten zum vollständig subkutanen ICD sind vielversprechend und haben zur erstmaligen Empfehlung für den S-ICD als Alternative zu einem konventionellen transvenösen ICD geführt. Der tragbare Kardioverter-Defibrillator hat ebenfalls erstmals Eingang in der aktuellen europäischen Leitlinie gefunden. Aktuelle Registerdaten untermauern den potenziellen Nutzen, insbesondere bei Patienten mit zu erwartender Erholung der linksventrikulären Funktion.
Abstract
The 2016 ESC guideline on prevention and therapy of ventricular tachyarrhythmias and sudden cardiac death present an excellent recommendation and summary for all forms of ventricular tachyarrhythmias in patients with and without structural or electrical heart disease. This includes cardiomyopathies as well as conditions such as proarrhythmia, neurologic/psychaitric disorders, or pregnancy. Some aspects are novel; (1) the guideline emphasizes for the first time genetic work-up in sudden cardiac death victims; (2) for prevention of sudden cardiac death systematic re-evaluation 6-12 weeks after myocardial infarction is recommended; (3) subcutaneous ICD as well as the wearable cardioverter/defibrillator are for the first time included in the guidelines; (4) automatic external defibrillators are recommended for public places; (5) for patients with recurrent ventricular tachyarrhythmias the role of catheter ablation has been upgraded.
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Literatur
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