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Erschienen in: Der Anaesthesist 8/2015

01.08.2015 | CME Zertifizierte Fortbildung

Perioperative Betreuung von Patienten mit Long-QT-Syndrom

verfasst von: T. Krönauer, Prof. Dr. P. Friederich

Erschienen in: Die Anaesthesiologie | Ausgabe 8/2015

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Zusammenfassung

Das Long-QT-Syndrom (LQTS) wird durch eine funktionelle Störung von Ionenkanälen des menschlichen Herzens verursacht, die mit der namengebenden Verlängerung des QT-Intervalls im Elektrokardiogramm (EKG) und einer Prädisposition für Herzrhythmusstörungen (z. B. Torsade de pointes, TdP) und kardiale Ereignisse bis zum plötzlichen Herztod einhergeht. Es wird zwischen einer angeborenen („congenital“, cLQTS) und einer erworbenen Form der Erkrankung („acquired“, aLQTS) unterschieden. Die Prävalenz des cLQTS wird mit 1:2000 angegeben; das aLQTS ist wesentlich häufiger und besitzt eine hohe Dunkelziffer von symptomfreien Betroffenen. Das cLQTS ist damit häufiger als die in der Anästhesiologie vielfach diskutierte maligne Hyperthermie (MH), der in der Bevölkerung eine Prävalenz zur Disposition von 1:3000 zugeordnet wird. Die Inzidenz wird mit einer Spannweite von 1:5000–1:100.000 Narkosen noch deutlich niedriger beziffert. Geht man von ca. 40.000 betroffenen Patienten mit cLQTS in Deutschland aus, müssen sich pro Jahr statistisch 5 bis 10 der Patienten mit cLQTS und noch deutlich mehr Patienten mit aLQTS einer Operation in Allgemeinanästhesie unterziehen. Daraus ergibt sich eine bislang in dieser Höhe nichtwahrgenommene Bedeutung dieses Krankheitsbilds, dessen potenziell tödliche Komplikationen bei Beachtung der im Folgenden dargelegten Vorgehensweise bestmöglich vermieden werden können und das LQTS im perioperativen Verlauf, auch bei Kindern, weitgehend beherrschbar machen.
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Metadaten
Titel
Perioperative Betreuung von Patienten mit Long-QT-Syndrom
verfasst von
T. Krönauer
Prof. Dr. P. Friederich
Publikationsdatum
01.08.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Die Anaesthesiologie / Ausgabe 8/2015
Print ISSN: 2731-6858
Elektronische ISSN: 2731-6866
DOI
https://doi.org/10.1007/s00101-015-0067-x