Zusammenfassung
Die Hochfrequenzstromablation hat sich in den letzten 20 Jahren zum Standardverfahren bei der Therapie von tachykarden Herzrhythmusstörungen entwickelt. Durch die Kombination mit neuen dreidimensionalen Bildgebungsverfahren steht zusammen mit so genannten Mappingverfahren eine Technik zur Verfügung, die die individuelle Anatomie des Patienten und die elektrophysiologische Information, d. h. den zeitlichen Ablauf der Erregungsfortleitung, darstellen kann. Diese Verfahren sind bei der Behandlung von komplexen Herzrhythmusstörungen, und hier insbesondere bei der Katheterablation von Vorhofflimmern, bedeutsam. Anstelle der aktuell „Punkt für Punkt“ angelegten Ablationslinien werden mittlerweile Ballonkatheterverfahren zur Applikation von Kryothermie, Ultraschall oder Laserenergie als „Single-shot-Technik“ erprobt, um die bei der Hochfrequenzstromablation häufiger auftretenden inkompletten Läsionen zu vermeiden. Schließlich verspricht die Magnetische Navigation als neues Steuerungsverfahren eine „schonendere“ Ablation, die vor allem durch die Reduktion der Strahlenbelastung von Vorteil ist.
Abstract
Radiofrequency current ablation has been developed over the last 20 years to be the standard approach for treating tachycardia by catheter ablation. By combining new 3-D imaging technology (CT and MRI) with 3-D electrophysiologic mapping systems, a new tool has been created to display the cardiac activation sequence of the individual. These technologies are extremely important for the treatment of complex arrhythmias such as the catheter ablation of atrial fibrillation. Instead of the conventional “point by point” linear ablation procedure, balloon catheters have been applied to a circumferential linear lesion in a “single shot” procedure using, for example, cryothermia, ultrasound or laser energy. Finally, magnetic navigation is a new steering tool for performing ablation procedures, leading to reduced exposure to ionizing radiation.
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Ernst, S., Kuck, KH. Neue Therapiemöglichkeiten für Arrhythmien durch Katheterablation. Internist 47, 1034–1039 (2006). https://doi.org/10.1007/s00108-006-1698-4
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DOI: https://doi.org/10.1007/s00108-006-1698-4