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Aktuelle Kardiologie 2016; 5(04): 276-281
DOI: 10.1055/s-0042-109062
Übersichtsarbeit
Georg Thieme Verlag KG Stuttgart · New York

Pulmonalvenenisolation bei asymptomatischem Vorhofflimmern

Pulmonary Vein Isolation for Asymptomatic Atrial Fibrillation
P. Leitz
Abteilung für Rhythmologie, Department für Kardiologie und Angiologie, Universitätsklinikum Münster
,
S. Kochhäuser
Abteilung für Rhythmologie, Department für Kardiologie und Angiologie, Universitätsklinikum Münster
,
K. Wasmer
Abteilung für Rhythmologie, Department für Kardiologie und Angiologie, Universitätsklinikum Münster
,
L. Eckardt
Abteilung für Rhythmologie, Department für Kardiologie und Angiologie, Universitätsklinikum Münster
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Publikationsverlauf

Publikationsdatum:
12. August 2016 (online)

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Zusammenfassung

Die Pulmonalvenenisolation (PVI) stellt eine etablierte Therapieoption für Patienten mit symptomatischem Vorhofflimmern (VHF) dar. Mehrere Studien konnten eine Überlegenheit des interventionellen Verfahrens im Vergleich zu einer rein medikamentösen Therapie belegen. Des Weiteren konnten verschiedene retrospektive Arbeiten Hinweise auf ein niedrigeres thrombembolisches Risiko nach stattgehabter PVI zeigen und so die Diskussion erneut anfeuern, ob eine PVI symptomatischen Patienten vorbehalten bleiben sollte. Zusätzlich stellt sich oft die Frage, ob initial asymptomatische Patienten im Verlauf eine Symptomatik entwickeln könnten. Bei jedoch aktuell fehlenden prospektiven, randomisierten Daten bezüglich eines prognostischen Vorteils einer PVI und in Anbetracht der prozeduralen Risiken sollte eine PVI nur in Einzelfällen bei asymptomatischen Patienten durchgeführt werden.

Abstract

Pulmonary vein isolation (PVI) is a proven therapeutic option for patients with symptomatic atrial fibrillation (AF). In many studies PVI has shown to be superior to antiarrhythmic drug therapy. Many recent publications hint towards an improved mortality and lower thrombembolic rate after successful ablation of AF and fuel the question if PVI should be reserved for symptomatic patients only. Additionally, it is unknown if a young and healthy patient with initially asymptomatic AF may become symptomatic in the future. However, to date, due to lack of prospective randomized trials, it remains unclear if PVI should be performed in asymptomatic AF. Given the procedural risks associated with PVI, it should only be performed in asymptomatic individuals on an individual basis.

Schlüsselwörter

Vorhofflimmern - Ablation - Schlaganfall

Key words

atrial fibrillation - ablation - stroke
 

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