ICD – Primärprävention: Was ist neu?

Zusammenfassung

Die Primärprävention des plötzlichen Herztods bleibt eine große Herausforderung. Verschiedene Studien konnten eine Risikoreduktion für den plötzlichen Herztod bei Patienten mit hochgradig eingeschränkter linksventrikulärer Funktion nach Myokardinfarkt und bei Patienten mit Herzinsuffizienz zeigen. Die aktuellen ECS-Leitlinien diskutieren intensiv die Indikationen für eine Primärprävention. Ein Großteil der zur Verfügung stehenden Daten ist verhältnismäßig alt und neue Daten stellen den Nutzen der ICD-Primärprävention bei Patienten mit z. B. dilatativer Kardiomyopathie infrage. Die Identifikation der Patienten, die tatsächlich von der primärprophylaktischen ICD-Implantation profitieren, ist eine wesentliche zukünftige Aufgabe.

Abstract

Primary prevention of sudden cardiac death remains a major task. Various studies have shown a risk reduction of sudden cardiac death in patients with severely reduced ejection fraction after myocardial infarction and/or patients with heart failure. Updated ESC guidelines intensively discuss indications for primary prevention in various clinical scenarios. However, most available data are relatively old and new data question the benefit of primary prevention with ICD in e.g. patients with dilated cardiomyopathy. Thus, optimal risk stratification remains a major task.

Schlüsselwörter

Primärprävention - plötzlicher Herztod - implantierbarer Kardioverter-Defibrillator

Key words

primary prevention - sudden cardiac death - implantable cardioverter-defibrillator

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