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Arrhythmien aus dem rechten Ventrikel

Right ventricular arrhythmias

  • Schwerpunkt: Der kranke rechte Ventrikel
  • Published:
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Zusammenfassung

Arrhythmien aus dem rechten Ventrikel treten bevorzugt bei jungen Patienten mit seltenen kardialen Erkrankungen auf. Wesentliche Grunderkrankungen sind die idiopathische rechtsventrikuläre Ausflusstrakt-Tachykardie (RVOT-VT), die arrhythmogene rechtsventrikuläre Kardiomyopathie (ARVC), das Brugada-Syndrom und angeborene Herzfehler (v. a. Fallot-Tetralogie). In Abhängigkeit von der zugrunde liegenden Erkrankung bestehen erhebliche Unterschiede in der Diagnostik, Therapie und Prognose, welche wesentlich durch den plötzlichen Herztod bestimmt wird. Für die optimale Versorgung der Patienten ist eine detaillierte Diagnostik und Risikostratifikation erforderlich. Die individuelle Therapiestrategie richtet sich nach der Grunderkrankung, Arrhythmiecharakteristik und dem Risiko des plötzlichen Herztodes und beinhaltet die antiarrhythmische Pharmakotherapie, die Katheterablation und die Implantation eines Cardioverter-Defibrillators.

Diese Übersicht fasst das aktuelle Wissen über die Pathogenese, Diagnostik, Therapie und Prognose der wesentlichen Erkrankungen zusammen, die mit Arrhythmien aus dem rechten Ventrikel einhergehen.

Abstract

Right ventricular arrhythmias predominantly occur in young patients with rare cardiac diseases. Underlying cardiac conditions include idiopathic right ventricular outflow-tract tachycardia (RVOT-VT), arrhythmogenic right ventricular cardiomyopathy (ARVC), Brugada syndrome, and postoperative congenital heart disease (i.e. tetralogy of Fallot). According to the underlying cardiac disease, there are significant differences in the diagnostic and therapeutic management and prognosis which is mainly determined by life-threatening ventricular arrhythmia recurrences and sudden cardiac death. To provide optimal treatment for affected patients, a detailed diagnostic evaluation and risk stratification is mandatory. Tailored treatment strategies aim at the suppression or effective termination of recurrent ventricular tachyarrhythmias and prevention of sudden death by antiarrhythmic drug therapy, catheter ablation, and the implantation of cardioverter-defibrillators.

This review summarizes the current knowledge on pathogenesis, diagnosis, treatment and prognosis of those conditions that are associated with arrhythmias originating from the right ventricle.

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Danksagung

Die Arbeit wurde erstellt mit Unterstützung durch die Deutsche Forschungsgemeinschaft (DFG), Bonn, Sonderforschungsbereich 556 (Projekt C4) und die Europäische Kommission, Brüssel, Belgien, 5th Framework Program 1998–2002 (QLG1-CT-2000–01091).

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Authors and Affiliations

  1. Medizinische Klinik und Poliklinik C (Kardiologie und Angiologie), Universitätsklinikum Münster

    T. Wichter, M. Paul, L. Eckardt & G. Breithardt

  2. Medizinische Klinik und Poliklinik C, Universitätsklinikum, Albert-Schweitzer-Straße 33, 48149, Münster

    T. Wichter

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  1. T. Wichter
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  2. M. Paul
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  3. L. Eckardt
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  4. G. Breithardt
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Correspondence to T. Wichter.

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Wichter, T., Paul, M., Eckardt, L. et al. Arrhythmien aus dem rechten Ventrikel. Internist 45, 1125–1135 (2004). https://doi.org/10.1007/s00108-004-1279-3

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  • DOI: https://doi.org/10.1007/s00108-004-1279-3

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