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Vorhofflimmern und Herzinsuffizienz

Atrial fibrillation and heart failure

  • Schwerpunkt: Herzrhythmusstörungen
  • Published:
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Zusammenfassung

Vorhofflimmern und Herzinsuffizienz zählen zu den häufigsten kardiovaskulären Erkrankungen und haben erheblichen Einfluss auf Mortalität und Morbidität der betroffenen Patienten. Pathophysiologisch haben die beiden Erkrankungen eine enge Beziehung zueinander und erhalten sich häufig gegenseitig aufrecht. Insofern ist eine effektive Therapie des Vorhofflimmerns inzwischen ein zentraler Bestandteil der modernen Herzinsuffizienztherapie. Basierend auf der aktuellen Datenlage sollte bei Patienten mit systolischer Herzinsuffizienz primär der Sinusrhythmus dauerhaft erhalten bleiben. Hier hat sich in der letzten Zeit die Katheterablation als vorteilhaft gegenüber einer rein medikamentösen Therapie erwiesen und ist somit Therapie der Wahl bei vielen Patienten mit Herzinsuffizienz und Vorhofflimmern. Bei Patienten mit diastolischer Herzinsuffizienz („heart failure with preserved ejection fraction“ [HFpEF]) ist der Effekt der Katheterablation weniger eindeutig. Hier werden dringend Daten aus randomisierten Studien benötigt, um die Wirksamkeit in diesem Kollektiv weiter abschätzen zu können.

Abstract

Atrial fibrillation and heart failure are among the most common cardiovascular diseases and have a significant impact on the mortality and morbidity of affected patients. From a pathophysiological perspective, the two diseases are closely related and often perpetuate each other. Therefore, effective management of atrial fibrillation is now a central component of modern heart failure treatment. Based on current data, sinus rhythm should primarily be permanently maintained in patients with systolic heart failure. Catheter ablation has recently proven to be advantageous over purely pharmacological therapy and is therefore the treatment of choice for many patients with heart failure and atrial fibrillation. In patients with diastolic heart failure (heart failure with preserved ejection fraction [HFpEF]), the effect of catheter ablation is less clear. Data from randomized studies are urgently needed in order to further assess efficacy in this population.

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  1. Abteilung für Kardiologie und Pneumologie, Universitätsmedizin Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland

    Leonard Bergau

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Bergau, L. Vorhofflimmern und Herzinsuffizienz. Innere Medizin (2024). https://doi.org/10.1007/s00108-024-01743-x

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