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Erschienen in: Die Anaesthesiologie 2/2024

29.01.2024 | Vorhofflimmern | CME

Perioperatives Vorhofflimmern

Diagnose mit unterschätzter Relevanz

verfasst von: Dr. med. Sebastian Adamowicz, Prof. Dr. med. Erich Kilger, Raphael Klarwein

Erschienen in: Die Anaesthesiologie | Ausgabe 2/2024

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Zusammenfassung

Vorhofflimmern (VHF) ist i. Allg. und auch perioperativ die häufigste Herzrhythmusstörung bei Erwachsenen und mit einer substanziellen Morbidität und Letalität assoziiert. Ein wesentlicher Risikofaktor ist das Alter der Patient*innen. Die Prävalenz des VHF bei nichtkardiochirurgischen Eingriffen (NCS) wird zwischen 0,4 und 30 % sowie bei kardiochirurgischen Operationen, insbesondere großen Kombinationseingriffen, bis ca. 50 % angegeben . Ektope Erregungszentren und Reentrymechanismen auf Vorhofebene werden als führende Prozesse der unkoordinierten elektrischen Vorhofaktivität favorisiert. Durch den Verlust der atrialen Kontraktion kann sich das Herzzeitvolumen (HZV) um bis zu 20–25 % reduzieren. Das aufgrund des VHF erhöhte Thromboembolierisiko hält über die Operation hinaus an. Medikamentöse Präventionsstrategien konnten sich noch nicht durchsetzen. Therapeutische Strategien umfassen die Frequenz- und Rhythmuskontrolle sowie die Vermeidung von Thromboembolien durch Antikoagulation.
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Metadaten
Titel
Perioperatives Vorhofflimmern
Diagnose mit unterschätzter Relevanz
verfasst von
Dr. med. Sebastian Adamowicz
Prof. Dr. med. Erich Kilger
Raphael Klarwein
Publikationsdatum
29.01.2024
Verlag
Springer Medizin
Erschienen in
Die Anaesthesiologie / Ausgabe 2/2024
Print ISSN: 2731-6858
Elektronische ISSN: 2731-6866
DOI
https://doi.org/10.1007/s00101-023-01375-0

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