Ventrikuläre Tachykardien – Behandlung in einer „VT-Unit“

Ventrikuläre Tachykardien (VT) sind eine der häufigsten Todesursachen von Patienten mit struktureller Herzerkrankung. Betroffene Patienten weisen häufig vielschichtige Komorbiditäten und eine erhöhte Mortalität auf. Die vielseitigen Ursachen sowie die zunehmenden Behandlungsmöglichkeiten erfordern insbesondere bei wiederholten oder nicht beherrschbaren VT eine umgehende und strukturierte Betreuung betroffener Patienten in einem speziell ausgebildeten Team aus Ärzten verschiedener Sub-Disziplinen, sowie Pflege- und technischem Personal. Vor diesem Hintergrund wurden an einigen Schwerpunktzentren in der jüngeren Vergangenheit gezielte Versorgungsstrukturen geschaffen, durch welche eine rasche und effiziente Behandlung von VT erreicht werden kann. Ziel der vorliegenden Arbeit ist es, mögliche Versorgungswege darzustellen. Aufgrund der zunehmenden Bedeutung der Katheterablation zur Modifizierung des zugrunde liegenden arrhythmogenen Substrats und neuer neuromodulatorischer Interventionen wird insbesondere auch auf periprozedurale Aspekte eingegangen, die in der Indikationsstellung sowie der Nachbetreuung der Patienten von besonderer Bedeutung sind.

Ventricular tachycardia (VT) are one of the most common causes of death in patients with structural heart disease. The increasing understanding of different etiologies and the rising number of therapeutical interventions of recurrent VT warrant an immedeate and structurized treatment in an interdisciplinary team of different health care professionals. Grounded in this knowledge dedicated VT units have been established in some centers. The aim of the present brief review is to discuss possible options which might increase health management in a relevant number of patients with VT who are at risk of sudden cardiac death. In the light of recent developments, we will address periprocedural aspects which are important for patients undergoing radiofrequency cather ablation for myocardial substrate modification and/or newer neuromodulating approaches.

Key words

Ventricular tachycardia (VT) - ICD - defibrillator - cardiogenic shock - cather ablation - neuromoduling

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