Kommentar zu den ESC-Leitlinien 2015 „Ventrikuläre Arrhythmien und Prävention des plötzlichen Herztodes“

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• 作者：Prof. Dr. T. Deneke ; M. Borggrefe ; G. Hindricks ; P. Kirchhof ; K.-H. Kuck…
• 关键词：SchlüsselwörterTachykardie ; Katheterablation ; Implantierbarer Kardioverter ; Defibrillator ; Risikostratifizierung ; Defibrillator ; Leitlinien
• 刊名：Der Kardiologe
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：11
• 期：1
• 页码：27-43
• 全文大小：
• 刊物主题：Internal Medicine; Cardiology; Pneumology/Respiratory System; Intensive / Critical Care Medicine; Emergency Medicine;
• 出版者：Springer Medizin
• ISSN：1864-9726
• 卷排序：11

文摘

The current 2015 guidelines of the European Society of Cardiology (ESC) on ventricular arrhythmias and the prevention of sudden cardiac death update the ESC guidelines from 2006 and incorporate multiple novel aspects and recommendations based on currently published data. This manuscript comments on the European recommendations with respect to the specific situation regarding the requirements of the healthcare structure in Germany. The new guidelines focus on the prevention of sudden cardiac death and include new information on ventricular arrhythmia associated with structural heart disease and congenital arrhythmia syndromes. New aspects in the guidelines include recommendations for autopsy clarification, including molecular genetic investigations in cases of sudden cardiac death. Detailed recommendations for subcutaneous and wearable defibrillators are given based on current data as well as psychosocial management after implantation of defibrillators and risk stratification early after myocardial infarction. Recommendations for cardiac resynchronization therapy have been adapted based on novel study outcomes and indications for implantable cardioverter defibrillators (ICD) in patients with non-ischemic cardiomyopathy were modified for Germany in the light of recently published randomized trials in comparison to European guidelines. The guidelines show a clear upgrading of catheter ablation for ventricular arrhythmia and recommendations for early interventional treatment after first onset of ventricular tachycardia. These comments discuss the novel aspects of each subject complex of the current European guidelines and in this context possible adaptations and modifications of the ESC guidelines for use in Germany from the perspective of the authors.