Langzeitergebnisse der Katheterablation bei AV-Knoten-Reentry-Tachykardien und akzessorischen Leitungsbahnen

Ann-Kathrin Kahle1,2, Fares-Alexander Alken2, Christian Meyer2,3, Ernan Zhu2, Katharina Scherschel2,3
1Klinik für Kardiologie, Pneumologie und Angiologie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
2Klinik für Kardiologie/Angiologie/Intensivmedizin, cNEP, cardiac Neuro- and Electrophysiology research group, Evangelisches Krankenhaus Düsseldorf, Düsseldorf, Deutschland
3Institut für Neuro- und Sinnesphysiologie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland

Tóm tắt

Die AV-Knoten-Reentry-Tachykardie (AVNRT) sowie AV-Reentry-Tachykardie (AVRT) bei akzessorischen Leitungsbahnen (AP) gehören zu den häufigsten supraventrikulären Tachykardien. Aktuelle Langzeitergebnisse der Katheterablation zeigen bei Kindern und Erwachsenen hohe Erfolgsraten von ca. 97 % (AVNRT) bzw. 92 % (AP). Das Risiko für schrittmacherpflichtige atrioventrikuläre (AV) Blockierungen liegt für die AVNRT bei 0,4–0,8 % bzw. für AP bei 0,1–0,2 %. Reduzierte Erfolgsraten von 87–93 % und erhöhte AV-Blockierungsraten bis zu 10 % zeigen sich bei Patient:innen mit komplexen kongenitalen Herzfehlern. Eine im Rahmen dyssynchroner Ventrikelerregung bei Präexzitation oder permanenten Reentry-Tachykardien auftretende Herzinsuffizienz zeigt nach Katheterablation eine hohe Remissionsrate von > 90 %. Zusammenfassend zeigt die Ablationstherapie von AVNRT und AP populationsübergreifend eine hohe Erfolgsrate bei sicherer Anwendbarkeit und stellt daher heute für die meisten Betroffenen die langfristige Therapie der ersten Wahl dar.

Tài liệu tham khảo

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