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Herzschrittmachertherapie + Elektrophysiologie

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14.02.2019 | Tachykarde Herzrhythmusstörungen | Elektrophysiologische Weiterbildung für Kardiologen

Ventrikuläre Extrasystolen und Tachykardien bei strukturell normalem Herz

Idiopathische VES und VT

verfasst von: PD Dr. Sonia Busch, Lars Eckardt, Philipp Sommer, Christian Meyer, Hendrik Bonnemeier, Dierk Thomas, Hans-Ruprecht Neuberger, Roland Richard Tilz, Daniel Steven, Christian von Bary, Malte Kuniss, Frederic Voss, Heidi L. Estner

Erschienen in: Herzschrittmachertherapie + Elektrophysiologie | Ausgabe 2/2019

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Zusammenfassung

Ventrikuläre Extrasystolen (VES) sind ein häufiger, oft zufälliger und meist harmloser Befund. Bei sehr häufigem Auftreten mit Beschwerden oder Verschlechterung der linksventrikulären Funktion besteht eine Behandlungsindikation. Idiopathische ventrikuläre Tachykardien (VT) finden sich überwiegend bei Patienten mit strukturell gesundem Herz. Diese VES/VT haben meist einen fokalen Ursprung. Der wahrscheinlichste Mechanismus sind verzögerte Nachdepolarisationen. Die Lokalisation des Ursprungortes basiert auf der Erstellung eines Aktivierungsmaps mit oder ohne Kombination eines Pacemappings. Die charakteristischen anatomischen Ursprungsstellen idiopathischer VES/VT sind die Ausflussbahnen des rechten und linken Ventrikels einschließlich der Aortenwurzel. Weitere typische Lokalisationen sind der Trikuspidal- oder Mitralklappenring, Papillarmuskeln und Purkinje-Fasern. Die Katheterablation ist bei symptomatischen, monomorphen VES/VT eine Alternative zu antiarrhythmischer Medikation. Die Erfolgsrate ist hoch, wobei das Mapping und die Ablation oftmals eine Herausforderung darstellen können. Dieser Artikel ist der fünfte Teil einer Serie zur gezielten Fort- und Weiterbildung im Bereich „Spezielle Rhythmologie – Invasive Elektrophysiologie“. Er beschreibt pathophysiologische Grundlagen, Formen sowie typische Befunde, die bei einer elektrophysiologischen Untersuchung erhoben werden können.

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Titel: Ventrikuläre Extrasystolen und Tachykardien bei strukturell normalem Herz
Idiopathische VES und VT
verfasst von: PD Dr. Sonia Busch
Lars Eckardt
Philipp Sommer
Christian Meyer
Hendrik Bonnemeier
Dierk Thomas
Hans-Ruprecht Neuberger
Roland Richard Tilz
Daniel Steven
Christian von Bary
Malte Kuniss
Frederic Voss
Heidi L. Estner
Publikationsdatum: 14.02.2019
Verlag: Springer Medizin
Schlagwörter: Tachykarde Herzrhythmusstörungen
Ablationstherapie
Ventrikuläre Tachykardien
EKG
EKG
Erschienen in: Herzschrittmachertherapie + Elektrophysiologie / Ausgabe 2/2019
Print ISSN: 0938-7412
Elektronische ISSN: 1435-1544
DOI: https://doi.org/10.1007/s00399-019-0607-1

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