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Ventrikuläre Tachykardien

Diagnostisches Spektrum und therapeutische Möglichkeiten

Ventricular tachycardia

Diagnostic spectrum and therapeutic measures

  • Schwerpunkt: Herzrhythmusstörungen
  • Published:
Der Internist Aims and scope Submit manuscript

Zusammenfassung

Der Ursprung ventrikulärer Tachyarrhythmien liegt unterhalb der Ventilebene des Herzens und umfasst verschiedene Erscheinungsformen wie monomorphe und polymorphe Kammertachykardien, Kammerflattern und Kammerflimmern. Da Übergänge zwischen den einzelnen Formen ventrikulärer Tachyarrhythmien häufig sind, sind ventrikuläre Tachyarrhythmien als prinzipiell bedrohlich anzusehen. Neben unterschiedlichen elektrophysiologischen Mechanismen wie Kreiserregung oder fokale Impulsbildung spielt sich das Auftreten von ventrikulären Tachyarrhythmien in einem individuellen biologischen Kontext ab: So treten ventrikuläre Tachyarrhythmien als Folge struktureller Herzerkrankungen auf oder sind bedingt durch primär elektrische Erkrankungen. Des Weiteren unterscheidet man ventrikuläre Tachyarrhythmien ohne fassbare strukturelle oder elektrische Grunderkrankung. Die Einordnung der Arrhythmie in diesen biologischen Zusammenhang ist für die Prognose, Differenzialtherapie und Langzeitbetreuung des Patienten von entscheidender Bedeutung.

Abstract

The origin of ventricular tachycardia lies in the ventricular tissue and includes a variety of symptoms such as monomorphic and polymorphic ventricular tachyarrhythmia (VT), ventricular flutter and ventricular fibrillation. Due to transitions of one form of VT to another, any form of VT incurs in principal the risk of cardiac failure. Apart from different electrophysiologic mechanisms such as reentry or triggered activity, any occurrence of VT has to be considered in an individual context: VT can be caused by structural heart disease such as coronary artery disease or dilative cardiomyopathy, or primary electrical disease such as long or short QT syndromes or can even occur without any detectable cause (idiopathic VT). Correct identification of the underlying cause of the arrhythmia is essential for the prognosis, differential therapy and long-term treatment of patients.

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  1. Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Sigmund-Freud-Straße 25, 53105 , Bonn, Deutschland

    T. Lewalter, J. O. Schwab & G. Nickenig

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  1. T. Lewalter
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  2. J. O. Schwab
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  3. G. Nickenig
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Correspondence to T. Lewalter.

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Lewalter, T., Schwab, J.O. & Nickenig, G. Ventrikuläre Tachykardien. Internist 47, 1001–1012 (2006). https://doi.org/10.1007/s00108-006-1708-6

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  • DOI: https://doi.org/10.1007/s00108-006-1708-6

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