[Isthmus-dependent right atrial flutter : Clinical course after isthmus ablation].
Rechtsatriales isthmusabhängiges Vorhofflattern : Klinischer Verlauf nach Isthmusablation.
Ablation
Cardiac arrhythmias
Cavotriscupid isthmus
Pulmonary vein isolation
Typical atrial flutter
Journal
Herzschrittmachertherapie & Elektrophysiologie
ISSN: 1435-1544
Titre abrégé: Herzschrittmacherther Elektrophysiol
Pays: Germany
ID NLM: 9425873
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
14
07
2023
accepted:
25
09
2023
medline:
28
11
2023
pubmed:
17
10
2023
entrez:
17
10
2023
Statut:
ppublish
Résumé
Ablation of the cavotricuspid isthmus (CTI) to create bidirectional isthmus blockade is the most effective way to achieve rhythm control in typical atrial flutter. Compared with drug therapy, ablation reduces cardiovascular mortality, all-cause mortality, stroke risk, and the risk of cardiac decompensation. Concomitant arrhythmia of atrial flutter is atrial fibrillation (AF); therefore the duration of oral anticoagulation should be adapted according to the risk of stroke and bleeding. A combined procedure of CTI ablation and pulmonary vein isolation (PVI) in patients with typical atrial flutter but without evidence of AF should be evaluated individually especially in patients aged > 54 years depending on (cardiac) comorbidities. The comprehensive diagnostic view should keep in mind not only arrhythmias but also possibly underlying coronary artery disease. Die Ablation des cavotrikuspidalen Isthmus (CTI) mit Schaffung einer bidirektionalen Isthmusblockade stellt die effektivste Art der Rhythmuskontrolle bei typischem Vorhofflattern dar. Im Vergleich zur medikamentösen Therapie senkt die Ablation die kardiovaskuläre Mortalität, die Gesamtmortalität, das Schlaganfallrisiko sowie das Risiko kardialer Dekompensationen. Vorhofflimmern besteht bei einem hohen Prozentsatz der Patienten nach der Vorhofflatterablation, worauf die Dauer der oralen Antikoagulation unter Berücksichtigung des Schlaganfall- und Blutungsrisikos abzustimmen ist. Ein kombinierter Eingriff von CTI-Ablation und Pulmonalvenenisolation (PVI) bei Patienten mit typischem Vorhofflattern, jedoch ohne Nachweis von Vorhofflimmern, kann individuell bei Patienten älter als 54 Jahre in Abhängigkeit der (kardialen) Komorbiditäten evaluiert werden. Der umfassende diagnostische Blick sollte nicht nur die Arrhythmie, sondern auch eine mögliche koronare Herzkrankheit (KHK) im Auge behalten.
Autres résumés
Type: Publisher
(ger)
Die Ablation des cavotrikuspidalen Isthmus (CTI) mit Schaffung einer bidirektionalen Isthmusblockade stellt die effektivste Art der Rhythmuskontrolle bei typischem Vorhofflattern dar. Im Vergleich zur medikamentösen Therapie senkt die Ablation die kardiovaskuläre Mortalität, die Gesamtmortalität, das Schlaganfallrisiko sowie das Risiko kardialer Dekompensationen. Vorhofflimmern besteht bei einem hohen Prozentsatz der Patienten nach der Vorhofflatterablation, worauf die Dauer der oralen Antikoagulation unter Berücksichtigung des Schlaganfall- und Blutungsrisikos abzustimmen ist. Ein kombinierter Eingriff von CTI-Ablation und Pulmonalvenenisolation (PVI) bei Patienten mit typischem Vorhofflattern, jedoch ohne Nachweis von Vorhofflimmern, kann individuell bei Patienten älter als 54 Jahre in Abhängigkeit der (kardialen) Komorbiditäten evaluiert werden. Der umfassende diagnostische Blick sollte nicht nur die Arrhythmie, sondern auch eine mögliche koronare Herzkrankheit (KHK) im Auge behalten.
Identifiants
pubmed: 37847416
doi: 10.1007/s00399-023-00966-z
pii: 10.1007/s00399-023-00966-z
doi:
Types de publication
English Abstract
Journal Article
Review
Langues
ger
Sous-ensembles de citation
IM
Pagination
291-297Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.
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