Antiarrhythmische Therapie asymptomatischer Herzrhythmusstörungen

Zusammenfassung

Asymptomatische Herzryhthmusstörungen bedürfen einer exakten kardiologischen Diagnostik. Diese beinhaltet eine ausführliche Anamnese, Familienanamnese und kardiologische Untersuchungen, die EKG, Belastungs-EKG, Langzeit-EKG, Echokardiografie und im Einzelfall weitere Spezialitäten umfassen. Dabei sind ggfs. Untersuchungen wie Kernspintomografie, Rechts- und Linksherzkatheter, Koronarangiografie und elektrophysiologische Diagnostik sinnvoll. Nur dann ist eine klare Definition des Risikos möglich. Eine primär medikamentöse antiarrhythmische Therapie bei asymptomatischen Patienten ist nicht belegt. Für Spezialfälle mag bei Patienten mit belastungsinduzierbaren supraventrikulären und ventrikulären Extrasystolen ohne Hinweis auf eine kardiale Erkrankung eine Betablockertherapie noch erlaubt sein. Regelmäßige kardiologische Kontrollen sind bei Patienten mit Herzrhythmusstörungen und arrhythmogenen Erkrankungen notwendig.

Abstract

Asymptomatic arrhythmias require exact cadiological diagnostic including detailed medical history, family history, cardiological examination, ECG, exercise ECG, Holter-ECG, echocardiography and others. Examinations like MRI, heart catheterization with left- and right ventricular angiography, coronary angiography and electrophysiological examination are useful for precise risk stratification. There is no evidence for efficiency in primarily medical antiarrhythmic therapy in asymptomatic patients. In some cases beta-blocker therapy may be considered for patients with exercise-induced supraventricular and ventricular extrasystoles. Regular cardiological controls are essential for patients suffering from arrhythmias.

Schlüsselwörter

asymptomatische Rhythmusstörungen - ventrikuläre Extrasystolie - Vorhofflimmern - Katheterablation

Key words

asymptomatic arrhythmias - atrial fibrillation - catheter ablation - ventricular extrasystoles

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