Idiopathisches Kammerflimmern – wie behandeln?

Zusammenfassung

Der plötzliche Herztod ist ein relativ häufiges Ereignis. Ein nur geringer Teil dieser plötzlichen Todesfälle betrifft allerdings idiopathisches Kammerflimmern. Von „idiopathischem“ Kammerflimmern sollte nur gesprochen werden, wenn eine strukturelle Herzerkrankung ebenso wie primäre Arrhythmiesyndrome ausgeschlossen werden konnten. In wenigen Einzelfällen ist eine Katheterablation früh einfallender ventrikulärer Extrasystolen ein kurativer Behandlungsansatz; ebenso kann im Einzelfall eine antiarrhythmische Therapie wirksam sein, wie Chinidin beim Syndrom der frühen Repolarisation. Eine Versorgung mit einem ICD-System zum Schutz vor einem plötzlichen Herztod ist daher in nahezu allen Fällen zwingend erforderlich.

Abstract

Sudden cardiac death is a regular occurrence in clinical medicine. Idiopathic ventricular fibrillation (VF) is a relatively rare subgroup, because it requires exclusion of structural heart disease as well as primary arrhythmia syndromes to establish this diagnosis. In some cases, catheter ablation of premature ventricular complexes may be curative. Moreover, some pharmacological treatment options like quinidine in early repolarization syndrome show promising preliminary results. However, ICD implantation is in all but very few cases of patients with idiopathic VF absolutely indispensable.

Schlüsselwörter

Kammerflimmern - idiopathisch - plötzlicher Herztod - Syndrom der frühen Repolarisation - Katheterablation

Key words

ventricular fibrillation - idiopathic - sudden cardiac death - early repolarization - catheter ablation

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