Aktuelle Leitlinien zum Vorhofflimmern

Die Diagnostik und Therapie des Vorhofflimmerns unterliegt einem stetigen Zuwachs an Fachwissen, wie die Leitlinien der europäischen Gesellschaft für Kardiologie (ESC) sowie der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) zur Diagnostik und dem Management von Vorhofflimmern in der klinischen Praxis zeigen. Beide Leitlinien werden im Folgenden miteinander verglichen.

Abstract

Atrial fibrillation is the most common persistent cardiac arrhythmia in adults. It is characterized by chaotic excitation of the atria, which leads to subsequent arrhythmic ventricular excitation. Due to the high prevalence of atrial fibrillation in the general population, patients with this diagnosis are found in all medical specialties. The diagnosis and treatment of atrial fibrillation are subject to a steady increase in specialist knowledge, as demonstrated by the guidelines of the European Society of Cardiology (ESC) and the Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) on the diagnosis and management of atrial fibrillation in clinical practice.

The two guidelines show a high degree of consistency in their recommendations for optimal evidence-based atrial fibrillation therapy, but there are also interesting differences in key aspects: atrial fibrillation screening, choice of anticoagulant, and recommendations for primary pulmonary vein isolation. Some of these recommendations are based on local conditions, such as the more frequent use of phenprocoumon over warfarin in Germany. However, some of them also represent a different interpretation of the scientific evidence. In summary, due to their textbook-like nature, both guidelines provide a good overview of the current management of atrial fibrillation patients.

Kernaussagen

• Die neuen AWMF-Leitlinien geben aktuelle evidenzbasierte Empfehlungen zum Management von Patient*innen mit Vorhofflimmern.

• Es besteht in weiten Teilen ein Konsens mit den ESC-Leitlinien, doch können interessante Unterschiede herausgestrichen werden.

• Eine frühe Rhythmuskontrolle rückt immer weiter in den Vordergrund.

• Die Pulmonalvenen-Isolation erhält eine zunehmende Bedeutung in der Erstlinien-Therapie.

Schlüsselwörter

ESC - AWMF - Leitlinienvergleich - Vorhofflimmermanagement

Keywords

ESC - AWMF - guideline comparison - AF management

Publication History

Article published online:
05 August 2025

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