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Erschienen in: Der Kardiologe 5/2014

01.10.2014 | Übersichten

Management des Vorhofflimmerns

Aktuelle und zukünftige Strategien

verfasst von: S. Hilbert, K. Bode, S. John, S. Kircher, A. Müssigbrodt, N. Dagres, Prof. Dr. G. Hindricks

Erschienen in: Die Kardiologie | Ausgabe 5/2014

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Zusammenfassung

In Europa leiden über 6 Mio. Menschen an Vorhofflimmern. Es wird geschätzt, dass sich die Prävalenz in den nächsten 50 Jahren verdoppeln wird. Das Hauptziel bei der Behandlung von Vorhofflimmern ist es, thrombembolische Komplikationen zu verhindern. Erreicht wird das durch den Einsatz oraler Antikoagulanzien, deren Auswahl sich am Risikoprofil (mithilfe von Risikoscores wie dem CHA2DS2-VASc-Score) und an den Komorbiditäten orientiert. Die weitere Behandlung ist symptomorientiert. Eine Frequenzkontrolle < 110/min in Ruhe scheint ausreichend zu sein. Bei hohem Leidensdruck wird eine rhythmuserhaltende Strategie mittels Kardioversion, Antiarrhythmika und Katheterablation verfolgt. Die Katheterablation von Vorhofflimmern hat zunehmenden Stellenwert und kann Erstlinientherapie sein. Inwieweit der Erhalt des Sinusrhythmus die Prognose von Vorhofflimmern beeinflusst, ist aktuell Gegenstand intensiver Forschung.
Literatur
1.
Zurück zum Zitat Camm AJ, Kirchhof P, Lip GYH et al (2010) Guidelines for the management of atrial fibrillation The Task Force for the Management of Atrial fibrillation of the European Society of Cardiology (ESC). Eur Heart J 31:2369–2429. doi:10.1093/eurheartj/ehq278PubMedCrossRef Camm AJ, Kirchhof P, Lip GYH et al (2010) Guidelines for the management of atrial fibrillation The Task Force for the Management of Atrial fibrillation of the European Society of Cardiology (ESC). Eur Heart J 31:2369–2429. doi:10.1093/eurheartj/ehq278PubMedCrossRef
2.
Zurück zum Zitat Heeringa J, Kuip DAM van der, Hofman A et al (2006) Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study. Eur Heart J 27:949–953. doi:10.1093/eurheartj/ehi825PubMedCrossRef Heeringa J, Kuip DAM van der, Hofman A et al (2006) Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study. Eur Heart J 27:949–953. doi:10.1093/eurheartj/ehi825PubMedCrossRef
3.
Zurück zum Zitat Currie CJ, Jones M, Goodfellow J et al (2006) Evaluation of survival and ischaemic and thromboembolic event rates in patients with non-valvar atrial fibrillation in the general population when treated and untreated with warfarin. Heart 92:196–200. doi:10.1136/hrt.2004.058339PubMedCrossRefPubMedCentral Currie CJ, Jones M, Goodfellow J et al (2006) Evaluation of survival and ischaemic and thromboembolic event rates in patients with non-valvar atrial fibrillation in the general population when treated and untreated with warfarin. Heart 92:196–200. doi:10.1136/hrt.2004.058339PubMedCrossRefPubMedCentral
4.
Zurück zum Zitat Wang TJ, Larson MG, Levy D et al (2003) Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality: the Framingham Heart Study. Circulation 107:2920–2925. doi:10.1161/01.CIR.0000072767.89944.6EPubMedCrossRef Wang TJ, Larson MG, Levy D et al (2003) Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality: the Framingham Heart Study. Circulation 107:2920–2925. doi:10.1161/01.CIR.0000072767.89944.6EPubMedCrossRef
5.
Zurück zum Zitat Camm JA, Lip GYH, De Caterina R et al (2012) 2012 focused update of the ESC Guidelines for the management of atrial fibrillation. Eur Heart J 33(21):2719–2747PubMedCrossRef Camm JA, Lip GYH, De Caterina R et al (2012) 2012 focused update of the ESC Guidelines for the management of atrial fibrillation. Eur Heart J 33(21):2719–2747PubMedCrossRef
6.
Zurück zum Zitat Page RL, Wilkinson WE, Clair WK et al (1994) Asymptomatic arrhythmias in patients with symptomatic paroxysmal atrial fibrillation and paroxysmal supraventricular tachycardia. Circulation 89:224–227PubMedCrossRef Page RL, Wilkinson WE, Clair WK et al (1994) Asymptomatic arrhythmias in patients with symptomatic paroxysmal atrial fibrillation and paroxysmal supraventricular tachycardia. Circulation 89:224–227PubMedCrossRef
7.
Zurück zum Zitat Israel CW, Grönefeld G, Ehrlich JR et al (2004) Long-term risk of recurrent atrial fibrillation as documented by an implantable monitoring device: implications for optimal patient care. J Am Coll Cardiol 43:47–52PubMedCrossRef Israel CW, Grönefeld G, Ehrlich JR et al (2004) Long-term risk of recurrent atrial fibrillation as documented by an implantable monitoring device: implications for optimal patient care. J Am Coll Cardiol 43:47–52PubMedCrossRef
8.
Zurück zum Zitat Allessie M, Ausma J, Schotten U (2002) Electrical, contractile and structural remodeling during atrial fibrillation. Cardiovasc Res 54:230–246. doi:10.1016/S0008-6363(02)00258-4PubMedCrossRef Allessie M, Ausma J, Schotten U (2002) Electrical, contractile and structural remodeling during atrial fibrillation. Cardiovasc Res 54:230–246. doi:10.1016/S0008-6363(02)00258-4PubMedCrossRef
9.
Zurück zum Zitat Frustaci A, Chimenti C, Bellocci F et al (1997) Histological substrate of atrial biopsies in patients with lone atrial fibrillation. Circulation 96:1180–1184. doi:10.1161/01.CIR.96.4.1180PubMedCrossRef Frustaci A, Chimenti C, Bellocci F et al (1997) Histological substrate of atrial biopsies in patients with lone atrial fibrillation. Circulation 96:1180–1184. doi:10.1161/01.CIR.96.4.1180PubMedCrossRef
10.
Zurück zum Zitat Nattel S, Burstein B, Dobrev D (2008) Atrial remodeling and atrial fibrillation mechanisms and implications. Circ Arrhythm Electrophysiol 1:62–73. doi:10.1161/CIRCEP.107.754564PubMedCrossRef Nattel S, Burstein B, Dobrev D (2008) Atrial remodeling and atrial fibrillation mechanisms and implications. Circ Arrhythm Electrophysiol 1:62–73. doi:10.1161/CIRCEP.107.754564PubMedCrossRef
11.
Zurück zum Zitat Schauerte P, Scherlag BJ, Pitha J et al (2000) Catheter ablation of cardiac autonomic nerves for prevention of vagal atrial fibrillation. Circulation 102:2774–2780. doi:10.1161/01.CIR.102.22.2774PubMedCrossRef Schauerte P, Scherlag BJ, Pitha J et al (2000) Catheter ablation of cardiac autonomic nerves for prevention of vagal atrial fibrillation. Circulation 102:2774–2780. doi:10.1161/01.CIR.102.22.2774PubMedCrossRef
12.
Zurück zum Zitat Pappone C, Santinelli V, Manguso F et al (2004) Pulmonary vein denervation enhances long-term benefit after circumferential ablation for paroxysmal atrial fibrillation. Circulation 109:327–334. doi:10.1161/01.CIR.0000112641.16340.C7PubMedCrossRef Pappone C, Santinelli V, Manguso F et al (2004) Pulmonary vein denervation enhances long-term benefit after circumferential ablation for paroxysmal atrial fibrillation. Circulation 109:327–334. doi:10.1161/01.CIR.0000112641.16340.C7PubMedCrossRef
13.
Zurück zum Zitat Elvan A, Pride HP, Eble JN, Zipes DP (1995) Radiofrequency catheter ablation of the atria reduces inducibility and duration of atrial fibrillation in dogs. Circulation 91:2235–2244. doi:10.1161/01.CIR.91.8.2235PubMedCrossRef Elvan A, Pride HP, Eble JN, Zipes DP (1995) Radiofrequency catheter ablation of the atria reduces inducibility and duration of atrial fibrillation in dogs. Circulation 91:2235–2244. doi:10.1161/01.CIR.91.8.2235PubMedCrossRef
14.
Zurück zum Zitat Goette A, Staack T, Röcken C et al (2000) Increased expression of extracellular signal-regulated kinase and angiotensin-converting enzyme in human atria during atrial fibrillation. J Am Coll Cardiol 35:1669–1677. doi:10.1016/S0735-1097(00)00611-2PubMedCrossRef Goette A, Staack T, Röcken C et al (2000) Increased expression of extracellular signal-regulated kinase and angiotensin-converting enzyme in human atria during atrial fibrillation. J Am Coll Cardiol 35:1669–1677. doi:10.1016/S0735-1097(00)00611-2PubMedCrossRef
15.
Zurück zum Zitat Friberg L, Rosenqvist M, Lip GYH (2012) Net clinical benefit of warfarin in patients with atrial fibrillation a report from the Swedish atrial fibrillation cohort study. Circulation 125:2298–2307. doi:10.1161/CIRCULATIONAHA.111.055079PubMedCrossRef Friberg L, Rosenqvist M, Lip GYH (2012) Net clinical benefit of warfarin in patients with atrial fibrillation a report from the Swedish atrial fibrillation cohort study. Circulation 125:2298–2307. doi:10.1161/CIRCULATIONAHA.111.055079PubMedCrossRef
16.
Zurück zum Zitat Lane DA, Lip GYH (2012) Use of the CHA2DS2-VASc and HAS-BLED scores to aid decision making for thromboprophylaxis in nonvalvular atrial fibrillation. Circulation 126:860–865. doi:10.1161/CIRCULATIONAHA.111.060061PubMedCrossRef Lane DA, Lip GYH (2012) Use of the CHA2DS2-VASc and HAS-BLED scores to aid decision making for thromboprophylaxis in nonvalvular atrial fibrillation. Circulation 126:860–865. doi:10.1161/CIRCULATIONAHA.111.060061PubMedCrossRef
17.
Zurück zum Zitat Heidbuchel H, Verhamme P, Alings M et al (2013) EHRA practical guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation: executive summary. Eur Heart J 34(27):2094–2106. doi:10.1093/eurheartj/eht134PubMedCrossRef Heidbuchel H, Verhamme P, Alings M et al (2013) EHRA practical guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation: executive summary. Eur Heart J 34(27):2094–2106. doi:10.1093/eurheartj/eht134PubMedCrossRef
18.
Zurück zum Zitat Connolly SJ, Eikelboom J, Joyner C et al (2011) Apixaban in patients with atrial fibrillation. N Engl J Med 364:806–817. doi:10.1056/NEJMoa1007432PubMedCrossRef Connolly SJ, Eikelboom J, Joyner C et al (2011) Apixaban in patients with atrial fibrillation. N Engl J Med 364:806–817. doi:10.1056/NEJMoa1007432PubMedCrossRef
19.
Zurück zum Zitat Connolly SJ, Ezekowitz MD, Yusuf S et al (2009) Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 361:1139–1151. doi:10.1056/NEJMoa0905561PubMedCrossRef Connolly SJ, Ezekowitz MD, Yusuf S et al (2009) Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 361:1139–1151. doi:10.1056/NEJMoa0905561PubMedCrossRef
20.
Zurück zum Zitat Granger CB, Alexander JH, McMurray JJV et al (2011) Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med 365:981–992. doi:10.1056/NEJMoa1107039PubMedCrossRef Granger CB, Alexander JH, McMurray JJV et al (2011) Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med 365:981–992. doi:10.1056/NEJMoa1107039PubMedCrossRef
21.
Zurück zum Zitat Patel MR, Mahaffey KW, Garg J et al (2011) Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med 365:883–891. doi:10.1056/NEJMoa1009638PubMedCrossRef Patel MR, Mahaffey KW, Garg J et al (2011) Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med 365:883–891. doi:10.1056/NEJMoa1009638PubMedCrossRef
22.
Zurück zum Zitat Connolly SJ, Pogue J, Eikelboom J et al (2008) Benefit of oral anticoagulant over antiplatelet therapy in atrial fibrillation depends on the quality of international normalized ratio control achieved by centers and countries as measured by time in therapeutic range. Circulation 118:2029–2037. doi:10.1161/CIRCULATIONAHA.107.750000PubMedCrossRef Connolly SJ, Pogue J, Eikelboom J et al (2008) Benefit of oral anticoagulant over antiplatelet therapy in atrial fibrillation depends on the quality of international normalized ratio control achieved by centers and countries as measured by time in therapeutic range. Circulation 118:2029–2037. doi:10.1161/CIRCULATIONAHA.107.750000PubMedCrossRef
23.
Zurück zum Zitat Gallagher AM, Setakis E, Plumb JM et al (2011) Risks of stroke and mortality associated with suboptimal anticoagulation in atrial fibrillation patients. Thromb Haemost 106:968–977. doi:10.1160/TH11-05-0353PubMedCrossRef Gallagher AM, Setakis E, Plumb JM et al (2011) Risks of stroke and mortality associated with suboptimal anticoagulation in atrial fibrillation patients. Thromb Haemost 106:968–977. doi:10.1160/TH11-05-0353PubMedCrossRef
24.
Zurück zum Zitat Morgan CL, McEwan P, Tukiendorf A et al (2009) Warfarin treatment in patients with atrial fibrillation: observing outcomes associated with varying levels of INR control. Thromb Res 124:37–41. doi:10.1016/j.thromres.2008.09.016PubMedCrossRef Morgan CL, McEwan P, Tukiendorf A et al (2009) Warfarin treatment in patients with atrial fibrillation: observing outcomes associated with varying levels of INR control. Thromb Res 124:37–41. doi:10.1016/j.thromres.2008.09.016PubMedCrossRef
25.
Zurück zum Zitat Wallentin L, Yusuf S, Ezekowitz MD et al (2010) Efficacy and safety of dabigatran compared with warfarin at different levels of international normalised ratio control for stroke prevention in atrial fibrillation: an analysis of the RE-LY trial. Lancet 376:975–983. doi:10.1016/S0140-6736(10)61194-4PubMedCrossRef Wallentin L, Yusuf S, Ezekowitz MD et al (2010) Efficacy and safety of dabigatran compared with warfarin at different levels of international normalised ratio control for stroke prevention in atrial fibrillation: an analysis of the RE-LY trial. Lancet 376:975–983. doi:10.1016/S0140-6736(10)61194-4PubMedCrossRef
26.
27.
Zurück zum Zitat ACTIVE Writing Group of the ACTIVE Investigators, Connolly S, Pogue J et al (2006) Clopidogrel plus aspirin versus oral anticoagulation for atrial fibrillation in the Atrial fibrillation Clopidogrel Trial with Irbesartan for prevention of Vascular Events (ACTIVE W): a randomised controlled trial. Lancet 367:1903–1912. doi:10.1016/S0140-6736(06)68845-4CrossRef ACTIVE Writing Group of the ACTIVE Investigators, Connolly S, Pogue J et al (2006) Clopidogrel plus aspirin versus oral anticoagulation for atrial fibrillation in the Atrial fibrillation Clopidogrel Trial with Irbesartan for prevention of Vascular Events (ACTIVE W): a randomised controlled trial. Lancet 367:1903–1912. doi:10.1016/S0140-6736(06)68845-4CrossRef
28.
Zurück zum Zitat ACTIVE Investigators, Connolly SJ, Pogue J et al (2009) Effect of clopidogrel added to aspirin in patients with atrial fibrillation. N Engl J Med 360:2066–2078. doi:10.1056/NEJMoa0901301CrossRef ACTIVE Investigators, Connolly SJ, Pogue J et al (2009) Effect of clopidogrel added to aspirin in patients with atrial fibrillation. N Engl J Med 360:2066–2078. doi:10.1056/NEJMoa0901301CrossRef
29.
Zurück zum Zitat Flaker GC, Eikelboom JW, Shestakovska O et al (2012) Bleeding during treatment with aspirin versus apixaban in patients with atrial fibrillation unsuitable for warfarin the apixaban versus acetylsalicylic acid to prevent stroke in atrial fibrillation patients who have failed or are unsuitable for vitamin K antagonist treatment (AVERROES) trial. Stroke 43:3291–3297. doi:10.1161/STROKEAHA.112.664144PubMedCrossRef Flaker GC, Eikelboom JW, Shestakovska O et al (2012) Bleeding during treatment with aspirin versus apixaban in patients with atrial fibrillation unsuitable for warfarin the apixaban versus acetylsalicylic acid to prevent stroke in atrial fibrillation patients who have failed or are unsuitable for vitamin K antagonist treatment (AVERROES) trial. Stroke 43:3291–3297. doi:10.1161/STROKEAHA.112.664144PubMedCrossRef
30.
Zurück zum Zitat Sardar P, Chatterjee S, Herzog E et al (2014) Novel oral anticoagulants in patients with renal insufficiency: a meta-analysis of randomized trials. Can J Cardiol 30:888–897. doi:10.1016/j.cjca.2014.04.015PubMedCrossRef Sardar P, Chatterjee S, Herzog E et al (2014) Novel oral anticoagulants in patients with renal insufficiency: a meta-analysis of randomized trials. Can J Cardiol 30:888–897. doi:10.1016/j.cjca.2014.04.015PubMedCrossRef
31.
Zurück zum Zitat Holmes DR, Reddy VY, Turi ZG et al (2009) Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial. Lancet 374:534–542. doi:10.1016/S0140-6736(09)61343-XPubMedCrossRef Holmes DR, Reddy VY, Turi ZG et al (2009) Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial. Lancet 374:534–542. doi:10.1016/S0140-6736(09)61343-XPubMedCrossRef
32.
Zurück zum Zitat Reddy VY, Doshi SK, Sievert H et al (2013) Percutaneous left atrial appendage closure for stroke prophylaxis in patients with atrial fibrillation: 2.3-year follow-up of the PROTECT AF (Watchman Left Atrial Appendage System for Embolic Protection in Patients with Atrial Fibrillation) trial. Circulation 127:720–729. doi:10.1161/CIRCULATIONAHA.112.114389PubMedCrossRef Reddy VY, Doshi SK, Sievert H et al (2013) Percutaneous left atrial appendage closure for stroke prophylaxis in patients with atrial fibrillation: 2.3-year follow-up of the PROTECT AF (Watchman Left Atrial Appendage System for Embolic Protection in Patients with Atrial Fibrillation) trial. Circulation 127:720–729. doi:10.1161/CIRCULATIONAHA.112.114389PubMedCrossRef
33.
Zurück zum Zitat Viles-Gonzalez JF, Kar S, Douglas P et al (2012) The clinical impact of incomplete left atrial appendage closure with the Watchman Device in patients with atrial fibrillation: a PROTECT AF (Percutaneous Closure of the Left Atrial Appendage Versus Warfarin Therapy for Prevention of Stroke in Patients With Atrial Fibrillation) substudy. J Am Coll Cardiol 59:923–929. doi:10.1016/j.jacc.2011.11.028PubMedCrossRef Viles-Gonzalez JF, Kar S, Douglas P et al (2012) The clinical impact of incomplete left atrial appendage closure with the Watchman Device in patients with atrial fibrillation: a PROTECT AF (Percutaneous Closure of the Left Atrial Appendage Versus Warfarin Therapy for Prevention of Stroke in Patients With Atrial Fibrillation) substudy. J Am Coll Cardiol 59:923–929. doi:10.1016/j.jacc.2011.11.028PubMedCrossRef
34.
Zurück zum Zitat Groenveld HF, Tijssen JGP, Crijns HJGM et al (2013) Rate control efficacy in permanent atrial fibrillation: successful and failed strict rate control against a background of lenient rate control: data from RACE II (Rate Control Efficacy in Permanent Atrial Fibrillation). J Am Coll Cardiol 61:741–748. doi:10.1016/j.jacc.2012.11.038PubMedCrossRef Groenveld HF, Tijssen JGP, Crijns HJGM et al (2013) Rate control efficacy in permanent atrial fibrillation: successful and failed strict rate control against a background of lenient rate control: data from RACE II (Rate Control Efficacy in Permanent Atrial Fibrillation). J Am Coll Cardiol 61:741–748. doi:10.1016/j.jacc.2012.11.038PubMedCrossRef
35.
Zurück zum Zitat Smit MD, Crijns HJGM, Tijssen JGP et al (2011) Effect of lenient versus strict rate control on cardiac remodeling in patients with atrial fibrillation: data of the RACE II (RAte Control Efficacy in permanent atrial fibrillation II) study. J Am Coll Cardiol 58:942–949. doi:10.1016/j.jacc.2011.04.030PubMedCrossRef Smit MD, Crijns HJGM, Tijssen JGP et al (2011) Effect of lenient versus strict rate control on cardiac remodeling in patients with atrial fibrillation: data of the RACE II (RAte Control Efficacy in permanent atrial fibrillation II) study. J Am Coll Cardiol 58:942–949. doi:10.1016/j.jacc.2011.04.030PubMedCrossRef
36.
Zurück zum Zitat Van Gelder IC, Groenveld HF, Crijns HJGM et al (2010) Lenient versus strict rate control in patients with atrial fibrillation. N Engl J Med 362:1363–1373. doi:10.1056/NEJMoa1001337CrossRef Van Gelder IC, Groenveld HF, Crijns HJGM et al (2010) Lenient versus strict rate control in patients with atrial fibrillation. N Engl J Med 362:1363–1373. doi:10.1056/NEJMoa1001337CrossRef
37.
Zurück zum Zitat Gheorghiade M, Fonarow GC, Veldhuisen DJ van et al (2013) Lack of evidence of increased mortality among patients with atrial fibrillation taking digoxin: findings from post hoc propensity-matched analysis of the AFFIRM trial. Eur Heart J 34:1489–1497. doi:10.1093/eurheartj/eht120PubMedCrossRefPubMedCentral Gheorghiade M, Fonarow GC, Veldhuisen DJ van et al (2013) Lack of evidence of increased mortality among patients with atrial fibrillation taking digoxin: findings from post hoc propensity-matched analysis of the AFFIRM trial. Eur Heart J 34:1489–1497. doi:10.1093/eurheartj/eht120PubMedCrossRefPubMedCentral
38.
Zurück zum Zitat Whitbeck MG, Charnigo RJ, Khairy P et al (2013) Increased mortality among patients taking digoxin – analysis from the AFFIRM study. Eur Heart J 34:1481–1488. doi:10.1093/eurheartj/ehs348PubMedCrossRef Whitbeck MG, Charnigo RJ, Khairy P et al (2013) Increased mortality among patients taking digoxin – analysis from the AFFIRM study. Eur Heart J 34:1481–1488. doi:10.1093/eurheartj/ehs348PubMedCrossRef
39.
Zurück zum Zitat Brignole M, Auricchio A, Baron-Esquivias G et al (2013) 2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy The Task Force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA). Eur Heart J 34(29):2281–2329. doi:10.1093/eurheartj/eht150PubMedCrossRef Brignole M, Auricchio A, Baron-Esquivias G et al (2013) 2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy The Task Force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA). Eur Heart J 34(29):2281–2329. doi:10.1093/eurheartj/eht150PubMedCrossRef
40.
Zurück zum Zitat Chatterjee NA, Upadhyay GA, Ellenbogen KA et al (2012) Atrioventricular nodal ablation in atrial fibrillation a meta-analysis and systematic review. Circ Arrhythm Electrophysiol 5:68–76. doi:10.1161/CIRCEP.111.967810PubMedCrossRef Chatterjee NA, Upadhyay GA, Ellenbogen KA et al (2012) Atrioventricular nodal ablation in atrial fibrillation a meta-analysis and systematic review. Circ Arrhythm Electrophysiol 5:68–76. doi:10.1161/CIRCEP.111.967810PubMedCrossRef
41.
Zurück zum Zitat Orlov MV, Gardin JM, Slawsky M et al (2010) Biventricular pacing improves cardiac function and prevents further left atrial remodeling in patients with symptomatic atrial fibrillation after atrioventricular node ablation. Am Heart J 159:264–270. doi:10.1016/j.ahj.2009.11.012PubMedCrossRef Orlov MV, Gardin JM, Slawsky M et al (2010) Biventricular pacing improves cardiac function and prevents further left atrial remodeling in patients with symptomatic atrial fibrillation after atrioventricular node ablation. Am Heart J 159:264–270. doi:10.1016/j.ahj.2009.11.012PubMedCrossRef
42.
Zurück zum Zitat Brignole M, Gammage M, Puggioni E et al (2005) Comparative assessment of right, left, and biventricular pacing in patients with permanent atrial fibrillation. Eur Heart J 26:712–722. doi:10.1093/eurheartj/ehi069PubMedCrossRef Brignole M, Gammage M, Puggioni E et al (2005) Comparative assessment of right, left, and biventricular pacing in patients with permanent atrial fibrillation. Eur Heart J 26:712–722. doi:10.1093/eurheartj/ehi069PubMedCrossRef
43.
Zurück zum Zitat Funck RC, Mueller H-H, Lunati M et al (2014) Characteristics of a large sample of candidates for permanent ventricular pacing included in the Biventricular Pacing for Atrio-ventricular Block to Prevent Cardiac Desynchronization Study (BioPace). Europace 16:354–362. doi:10.1093/europace/eut343PubMedCrossRef Funck RC, Mueller H-H, Lunati M et al (2014) Characteristics of a large sample of candidates for permanent ventricular pacing included in the Biventricular Pacing for Atrio-ventricular Block to Prevent Cardiac Desynchronization Study (BioPace). Europace 16:354–362. doi:10.1093/europace/eut343PubMedCrossRef
44.
Zurück zum Zitat Crijns HJGM, Weijs B, Fairley A-M et al (2014) Contemporary real life cardioversion of atrial fibrillation: results from the multinational RHYTHM-AF study. Int J Cardiol 172:588–594. doi:10.1016/j.ijcard.2014.01.099PubMedCrossRef Crijns HJGM, Weijs B, Fairley A-M et al (2014) Contemporary real life cardioversion of atrial fibrillation: results from the multinational RHYTHM-AF study. Int J Cardiol 172:588–594. doi:10.1016/j.ijcard.2014.01.099PubMedCrossRef
45.
Zurück zum Zitat Alboni P, Botto GL, Baldi N et al (2004) Outpatient treatment of recent-onset atrial fibrillation with the „pill-in-the-pocket“ approach. N Engl J Med 351:2384–2391. doi:10.1056/NEJMoa041233PubMedCrossRef Alboni P, Botto GL, Baldi N et al (2004) Outpatient treatment of recent-onset atrial fibrillation with the „pill-in-the-pocket“ approach. N Engl J Med 351:2384–2391. doi:10.1056/NEJMoa041233PubMedCrossRef
46.
Zurück zum Zitat Connolly SJ, Camm AJ, Halperin JL et al (2011) Dronedarone in high-risk permanent atrial fibrillation. N Engl J Med 365:2268–2276. doi:10.1056/NEJMoa1109867PubMedCrossRef Connolly SJ, Camm AJ, Halperin JL et al (2011) Dronedarone in high-risk permanent atrial fibrillation. N Engl J Med 365:2268–2276. doi:10.1056/NEJMoa1109867PubMedCrossRef
47.
Zurück zum Zitat Noheria A, Kumar A, Wylie JV Jr, Josephson ME (2008) Catheter ablation vs antiarrhythmic drug therapy for atrial fibrillation: a systematic review. Arch Intern Med 168:581–586. doi:10.1001/archinte.168.6.581PubMedCrossRef Noheria A, Kumar A, Wylie JV Jr, Josephson ME (2008) Catheter ablation vs antiarrhythmic drug therapy for atrial fibrillation: a systematic review. Arch Intern Med 168:581–586. doi:10.1001/archinte.168.6.581PubMedCrossRef
48.
Zurück zum Zitat Piccini JP, Lopes RD, Kong MH et al (2009) Pulmonary vein isolation for the maintenance of sinus rhythm in patients with atrial fibrillation a meta-analysis of randomized, controlled trials. Circ Arrhythm Electrophysiol 2:626–633. doi:10.1161/CIRCEP.109.856633PubMedCrossRef Piccini JP, Lopes RD, Kong MH et al (2009) Pulmonary vein isolation for the maintenance of sinus rhythm in patients with atrial fibrillation a meta-analysis of randomized, controlled trials. Circ Arrhythm Electrophysiol 2:626–633. doi:10.1161/CIRCEP.109.856633PubMedCrossRef
49.
Zurück zum Zitat Cappato R, Calkins H, Chen S-A et al (2010) Updated worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation. Circ Arrhythm Electrophysiol 3:32–38. doi:10.1161/CIRCEP.109.859116PubMedCrossRef Cappato R, Calkins H, Chen S-A et al (2010) Updated worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation. Circ Arrhythm Electrophysiol 3:32–38. doi:10.1161/CIRCEP.109.859116PubMedCrossRef
50.
Zurück zum Zitat Sommer P, Rolf S, Piorkowski C et al (2014) Non-fluoroscopic catheter visualization in AF ablation: experience from 375 consecutive procedures. Circ Arrhythm Electrophysiol. doi:10.1161/CIRCEP.114.001542 [Epub ahead of print] Sommer P, Rolf S, Piorkowski C et al (2014) Non-fluoroscopic catheter visualization in AF ablation: experience from 375 consecutive procedures. Circ Arrhythm Electrophysiol. doi:10.1161/CIRCEP.114.001542 [Epub ahead of print]
51.
Zurück zum Zitat Ouyang F, Tilz R, Chun J et al (2010) Long-term results of catheter ablation in paroxysmal atrial fibrillation lessons from a 5-year follow-up. Circulation 122:2368–2377. doi:10.1161/CIRCULATIONAHA.110.946806PubMedCrossRef Ouyang F, Tilz R, Chun J et al (2010) Long-term results of catheter ablation in paroxysmal atrial fibrillation lessons from a 5-year follow-up. Circulation 122:2368–2377. doi:10.1161/CIRCULATIONAHA.110.946806PubMedCrossRef
52.
Zurück zum Zitat Oral H, Chugh A, Yoshida K et al (2009) A randomized assessment of the incremental role of ablation of complex fractionated atrial electrograms after antral pulmonary vein isolation for long-lasting persistent atrial fibrillation. J Am Coll Cardiol 53:782–789. doi:10.1016/j.jacc.2008.10.054PubMedCrossRef Oral H, Chugh A, Yoshida K et al (2009) A randomized assessment of the incremental role of ablation of complex fractionated atrial electrograms after antral pulmonary vein isolation for long-lasting persistent atrial fibrillation. J Am Coll Cardiol 53:782–789. doi:10.1016/j.jacc.2008.10.054PubMedCrossRef
53.
Zurück zum Zitat La Meir M (2013) New technologies and hybrid surgery for atrial fibrillation. Rambam Maimonides Med J. doi:10.5041/RMMJ.10116 La Meir M (2013) New technologies and hybrid surgery for atrial fibrillation. Rambam Maimonides Med J. doi:10.5041/RMMJ.10116
54.
Zurück zum Zitat Zembala MO, Suwalski P (2013) Minimally invasive surgery for atrial fibrillation. J Thorac Dis 5:S704–S712. doi:10.3978/j.issn.2072-1439.2013.10.17PubMedPubMedCentral Zembala MO, Suwalski P (2013) Minimally invasive surgery for atrial fibrillation. J Thorac Dis 5:S704–S712. doi:10.3978/j.issn.2072-1439.2013.10.17PubMedPubMedCentral
55.
Zurück zum Zitat Mardigyan V, Verma A, Birnie D et al (2013) Anticoagulation management pre- and post atrial fibrillation ablation: a survey of canadian centres. Can J Cardiol 29:219–223. doi:10.1016/j.cjca.2012.04.013PubMedCrossRef Mardigyan V, Verma A, Birnie D et al (2013) Anticoagulation management pre- and post atrial fibrillation ablation: a survey of canadian centres. Can J Cardiol 29:219–223. doi:10.1016/j.cjca.2012.04.013PubMedCrossRef
56.
Zurück zum Zitat Lakkireddy D, Reddy YM, Di Biase L et al (2014) Feasibility and safety of uninterrupted rivaroxaban for periprocedural anticoagulation in patients undergoing radiofrequency ablation for atrial fibrillation: results from a multicenter prospective registry. J Am Coll Cardiol 63:982–988. doi:10.1016/j.jacc.2013.11.039PubMedCrossRef Lakkireddy D, Reddy YM, Di Biase L et al (2014) Feasibility and safety of uninterrupted rivaroxaban for periprocedural anticoagulation in patients undergoing radiofrequency ablation for atrial fibrillation: results from a multicenter prospective registry. J Am Coll Cardiol 63:982–988. doi:10.1016/j.jacc.2013.11.039PubMedCrossRef
57.
Zurück zum Zitat Bassiouny M, Saliba W, Rickard J et al (2013) Use of dabigatran for periprocedural anticoagulation in patients undergoing catheter ablation for atrial fibrillation. Circ Arrhythm Electrophysiol 6:460–466. doi:10.1161/CIRCEP.113.000320PubMedCrossRefPubMedCentral Bassiouny M, Saliba W, Rickard J et al (2013) Use of dabigatran for periprocedural anticoagulation in patients undergoing catheter ablation for atrial fibrillation. Circ Arrhythm Electrophysiol 6:460–466. doi:10.1161/CIRCEP.113.000320PubMedCrossRefPubMedCentral
58.
Zurück zum Zitat Tan TC, Koutsogeorgis ΙD, Grapsa J et al (2014) Left atrium and the imaging of atrial fibrosis: catch it if you can! Eur J Clin Invest 44(9):872–881. doi:10.1111/eci.12305PubMedCrossRef Tan TC, Koutsogeorgis ΙD, Grapsa J et al (2014) Left atrium and the imaging of atrial fibrosis: catch it if you can! Eur J Clin Invest 44(9):872–881. doi:10.1111/eci.12305PubMedCrossRef
59.
Zurück zum Zitat Hauser TH, Peters DC, Wylie JV, Manning WJ (2008) Evaluating the left atrium by magnetic resonance imaging. Europace 10:iii22–iii27. doi:10.1093/europace/eun223PubMedCrossRefPubMedCentral Hauser TH, Peters DC, Wylie JV, Manning WJ (2008) Evaluating the left atrium by magnetic resonance imaging. Europace 10:iii22–iii27. doi:10.1093/europace/eun223PubMedCrossRefPubMedCentral
60.
Zurück zum Zitat Celik H, Ramanan V, Barry J et al (2014) Intrinsic contrast for characterization of acute radiofrequency ablation lesions. Circ Arrhythm Electrophysiol 7(4):718–727. doi:10.1161/CIRCEP.113.001163PubMedCrossRef Celik H, Ramanan V, Barry J et al (2014) Intrinsic contrast for characterization of acute radiofrequency ablation lesions. Circ Arrhythm Electrophysiol 7(4):718–727. doi:10.1161/CIRCEP.113.001163PubMedCrossRef
61.
Zurück zum Zitat Nakagawa H, Ikeda A, Sharma T et al (2012) Rapid high resolution electroanatomical mapping: evaluation of a new system in a canine atrial linear lesion model. Circ Arrhythm Electrophysiol 5:417–424. doi:10.1161/CIRCEP.111.968602PubMedCrossRef Nakagawa H, Ikeda A, Sharma T et al (2012) Rapid high resolution electroanatomical mapping: evaluation of a new system in a canine atrial linear lesion model. Circ Arrhythm Electrophysiol 5:417–424. doi:10.1161/CIRCEP.111.968602PubMedCrossRef
62.
Zurück zum Zitat Haïssaguerre M, Hocini M, Denis A et al (2014) Driver domains in persistent atrial fibrillation. Circulation 130(7):530–538PubMedCrossRef Haïssaguerre M, Hocini M, Denis A et al (2014) Driver domains in persistent atrial fibrillation. Circulation 130(7):530–538PubMedCrossRef
63.
Zurück zum Zitat Schricker AA, Lalani GG, Krummen DE, Narayan SM (2014) Rotors as drivers of atrial fibrillation and targets for ablation. Curr Cardiol Rep 16:509. doi:10.1007/s11886-014-0509-0PubMedCrossRef Schricker AA, Lalani GG, Krummen DE, Narayan SM (2014) Rotors as drivers of atrial fibrillation and targets for ablation. Curr Cardiol Rep 16:509. doi:10.1007/s11886-014-0509-0PubMedCrossRef
64.
Zurück zum Zitat Pokushalov E, Romanov A, Katritsis DG et al (2014) Renal denervation for improving outcomes of catheter ablation in patients with atrial fibrillation and hypertension: early experience. Heart Rhythm 11:1131–1138. doi:10.1016/j.hrthm.2014.03.055PubMedCrossRef Pokushalov E, Romanov A, Katritsis DG et al (2014) Renal denervation for improving outcomes of catheter ablation in patients with atrial fibrillation and hypertension: early experience. Heart Rhythm 11:1131–1138. doi:10.1016/j.hrthm.2014.03.055PubMedCrossRef
65.
Zurück zum Zitat Linz D, Wirth K, Ukena C et al (2013) Renal denervation suppresses ventricular arrhythmias during acute ventricular ischemia in pigs. Heart Rhythm 10:1525–1530. doi:10.1016/j.hrthm.2013.07.015PubMedCrossRef Linz D, Wirth K, Ukena C et al (2013) Renal denervation suppresses ventricular arrhythmias during acute ventricular ischemia in pigs. Heart Rhythm 10:1525–1530. doi:10.1016/j.hrthm.2013.07.015PubMedCrossRef
66.
Zurück zum Zitat Huxley RR, Misialek JR, Agarwal SK et al (2014) Physical activity, obesity, weight change and risk of atrial fibrillation: the Atherosclerosis Risk in Communities (ARIC) Study. Circ Arrhythm Electrophysiol 7(4):620–625PubMedCrossRef Huxley RR, Misialek JR, Agarwal SK et al (2014) Physical activity, obesity, weight change and risk of atrial fibrillation: the Atherosclerosis Risk in Communities (ARIC) Study. Circ Arrhythm Electrophysiol 7(4):620–625PubMedCrossRef
67.
Zurück zum Zitat Abed HS, Wittert GA, Leong DP et al (2013) Effect of weight reduction and cardiometabolic risk factor management on symptom burden and severity in patients with atrial fibrillation: a randomized clinical trial. JAMA 310:2050–2060. doi:10.1001/jama.2013.280521PubMedCrossRef Abed HS, Wittert GA, Leong DP et al (2013) Effect of weight reduction and cardiometabolic risk factor management on symptom burden and severity in patients with atrial fibrillation: a randomized clinical trial. JAMA 310:2050–2060. doi:10.1001/jama.2013.280521PubMedCrossRef
68.
Zurück zum Zitat Larsson SC, Drca N, Wolk A (2014) Alcohol consumption and risk of atrial fibrillation: a prospective study and dose-response meta-analysis. J Am Coll Cardiol 64:281–289. doi:10.1016/j.jacc.2014.03.048PubMedCrossRef Larsson SC, Drca N, Wolk A (2014) Alcohol consumption and risk of atrial fibrillation: a prospective study and dose-response meta-analysis. J Am Coll Cardiol 64:281–289. doi:10.1016/j.jacc.2014.03.048PubMedCrossRef
69.
Zurück zum Zitat Cheng M, Hu Z, Lu X et al (2014) Caffeine intake and atrial fibrillation incidence: dose response meta-analysis of prospective cohort studies. Can J Cardiol 30:448–454. doi:10.1016/j.cjca.2013.12.026PubMedCrossRef Cheng M, Hu Z, Lu X et al (2014) Caffeine intake and atrial fibrillation incidence: dose response meta-analysis of prospective cohort studies. Can J Cardiol 30:448–454. doi:10.1016/j.cjca.2013.12.026PubMedCrossRef
Metadaten
Titel
Management des Vorhofflimmerns
Aktuelle und zukünftige Strategien
verfasst von
S. Hilbert
K. Bode
S. John
S. Kircher
A. Müssigbrodt
N. Dagres
Prof. Dr. G. Hindricks
Publikationsdatum
01.10.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Die Kardiologie / Ausgabe 5/2014
Print ISSN: 2731-7129
Elektronische ISSN: 2731-7137
DOI
https://doi.org/10.1007/s12181-014-0613-9

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