Die Behandlung von Vorhofflimmern im Alltag
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Die Behandlung von Vorhofflimmern im Alltag. / Meinertz, T; Willems, S.
in: INTERNIST, Jahrgang 49, Nr. 12, 12.2008, S. 1437-1442.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Review › Forschung
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TY - JOUR
T1 - Die Behandlung von Vorhofflimmern im Alltag
AU - Meinertz, T
AU - Willems, S
PY - 2008/12
Y1 - 2008/12
N2 - Atrial fibrillation is the most common arrhythmia in the adult. During recent years the therapeutic strategy has markedly changed. Some of these changes can be summarized as follows: Basis therapy includes betablockers and - in patients with structural heart disease - ACE-inhibitors and AT(1)-Blockers respectively. Class 1C-antiarrhythmic agents (flecainide or propafenon) should be restricted to patients with no or minimal left ventricular impairment. Amiodaron is the drug of choice in patients refractory to class 1C-agents and in those with already reduced left ventricular function. The "pill-in-the-pocket" regime can be used successfully in patients without structural heart disease and rare episodes of atrial fibrillation.Catheter ablation for paroxysmal and short lasting chronic atrial fibrillation was introduced into the clinical practice in 2006. The European and US-American guidelines recommend this technique for patients with no or minimal structural heart disease who are highly symptomatic and refractory or intolerant to antiarrhythmic agents. Decisions for curative catheter ablation in patients with long standing atrial fibrillation, heart failure or valvular heart disease should be individualized but are to date not generally recommended.
AB - Atrial fibrillation is the most common arrhythmia in the adult. During recent years the therapeutic strategy has markedly changed. Some of these changes can be summarized as follows: Basis therapy includes betablockers and - in patients with structural heart disease - ACE-inhibitors and AT(1)-Blockers respectively. Class 1C-antiarrhythmic agents (flecainide or propafenon) should be restricted to patients with no or minimal left ventricular impairment. Amiodaron is the drug of choice in patients refractory to class 1C-agents and in those with already reduced left ventricular function. The "pill-in-the-pocket" regime can be used successfully in patients without structural heart disease and rare episodes of atrial fibrillation.Catheter ablation for paroxysmal and short lasting chronic atrial fibrillation was introduced into the clinical practice in 2006. The European and US-American guidelines recommend this technique for patients with no or minimal structural heart disease who are highly symptomatic and refractory or intolerant to antiarrhythmic agents. Decisions for curative catheter ablation in patients with long standing atrial fibrillation, heart failure or valvular heart disease should be individualized but are to date not generally recommended.
KW - Acute Disease
KW - Amiodarone/therapeutic use
KW - Anti-Arrhythmia Agents/therapeutic use
KW - Atrial Fibrillation/diagnosis
KW - Catheter Ablation
KW - Chronic Disease
KW - Electric Countershock
KW - Humans
KW - Internal Medicine
KW - Secondary Prevention
U2 - 10.1007/s00108-008-2152-6
DO - 10.1007/s00108-008-2152-6
M3 - SCORING: Review
C2 - 19020848
VL - 49
SP - 1437
EP - 1442
JO - INTERNIST
JF - INTERNIST
SN - 0020-9554
IS - 12
ER -