Katheterablation von ventrikulären Tachykardien und ventrikulären Extrasystolen

Zusammenfassung

Die Ablation einer VT oder VES ist mittlerweile eine etablierte Therapie. Sie ist einer medikamentösen antiarrhythmischen Therapie oft überlegen, da sie direkt das elektroanatomische Substrat behandelt und in erfahrenen Zentren nur mit einem geringen Risiko behaftet ist. Durch die Anwendung elektroanatomischer Mapping-Verfahren und der Verwendung spezieller Ablationskatheter wird die anatomische Lokalisation vereinfacht und die Rezidivrate gesenkt. Über den geeigneten Zeitpunkt einer Ablation herrscht noch Uneinigkeit. Diesbezüglich sind noch weitere Studien erforderlich, insbesondere auch zur Beurteilung einer VT-Ablation bei struktureller Herzerkrankung mit erhaltener LV-Funktion als Alternative zur ICD-Implantation.

Abstract

The ablation of ventricular arrhythmias has become an established therapy. This therapy is in most circumstances superior to an exclusive drug therapy because it is dealing with the arrhythmogene substrate. Moreover its complication rate is less performed in experienced centres. The development of three-dimensional mapping systems and the use of specific ablation catheters has guided the ablation of ventricular tachycardia or ventricular extrasystolia towards a more sufficient and safer ablation approach. There is an ongoing discussion about the right moment of ablation especially in patients with structural heart disease with preserved left ventricular function as an alternative treatment instead of a lifelong ICD implantation.

Schlüsselwörter

ventrikuläre Tachykardie - ventrikuläre Extrasystolie - 3-D-Mapping-Verfahren - Kardiomyopathie - Defibrillator

Key words

ventricular arrhythmias - 3D mapping - cardio myopathy - ICD-theraphy - ablation

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