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Kardiologie up2date 2006; 2(2): 110-113
DOI: 10.1055/s-2006-944535
Hotline - Herzrhythmusstörungen
© Georg Thieme Verlag Stuttgart · New York

Wie schädlich ist die rechtsventrikuläre Stimulation?

Andreas  Schuchert
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Publication History

Publication Date:
31 July 2006 (online)

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Einleitung

Die beiden häufigsten Indikationen zur Implantation eines permanenten Herzschrittmachers sind das symptomatische Sinusknotensyndrom und höhergradige AV-Blockierungen. Bei beiden Rhythmusstörungen empfehlen die Leitlinien, die physiologische Erregungsausbreitung wiederzustellen [1] [2]. In der klinischen Praxis führte dies zu einer Zunahme der Zweikammersysteme auf Kosten der VVI-Schrittmacher [3]. Die Implantation eines AAI-Schrittmachers ist in Deutschland mit um die 3 % selten geblieben.

Nach der Implantation wurde die Einstellung der Schrittmacher bei vielen Patienten nicht verändert, d. h., die werkmäßige Vorgabe wurde übernommen und nicht individuell eingestellt. Zweikammerschrittmacher wurden so im DDD-Modus mit einer AV-Zeit von etwa 150 ms belassen. Bereits im EKG ist anhand des Spike mit dem schrittmachergetriggerten Linksschenkelblock zu erkennen, dass der Patient Schrittmacherträger ist.

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Prof. Dr. med. Andreas Schuchert

Medizinische Klinik

Friedrich-Ebert-Krankenhaus · Friesenstraße 11 · 24534 Neumünster

Email: andreas.schuchert@fek.de

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