Radiopraxis 2023; 16(04): 182-191
DOI: 10.1055/a-1811-0668
CPD-Fortbildung

Techniken der Pulmonalvenenisolation

Techniques of pulmonary vein isolation
Kerstin Hartmann
,
Lisa Techt

Vorhofflimmern gehört zu den häufigsten Herzrhythmusstörungen und zieht eine Reihe von Folgeerkrankungen nach sich, z. B. Schlaganfälle oder die Entwicklung einer Herzinsuffizienz. Eine in der klinischen Routine häufig eingesetzte, invasive Therapieform ist die Pulmonalvenenisolation. Dieser Artikel beschäftigt sich mit 3 unterschiedlichen Techniken, die hierfür eingesetzt werden.

Abstract

Atrial fibrillation is one of the most common cardiac arrhythmias and is associated with a reduction in quality of life if left untreated. A very well-established, safe, and invasive form of therapy is pulmonary vein isolation. Pulmonary vein isolation techniques can be divided into two types: thermal and nonthermal approach, and point-by-point and single-shot procedures. Radiofrequency ablation is a thermal point-by-point technique. An essential component is the use of a 3D mapping system, that allows the visualization of the left atrium and the catheters used without fluoroscopy. Cryoablation is one of the single-shot techniques. Here, liquid nitrogen is filled into a balloon that is positioned against the ostium of the pulmonary veins, isolating it in a single delivery. A new single-shot technique is the pulsed-field ablation, based on the principle of electroporation. By using this technology, collateral damage such as injury to the phrenic nerve or esophagus is prevented. All three methods have very good success rates in the treatment of atrial fibrillation.



Publikationsverlauf

Artikel online veröffentlicht:
28. November 2023

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