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Elektrische Therapie von Vorhofflimmern und Vorhofflattern

  • Chapter
Vorhofflimmern

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Zusammenfassung

Die erste Kardioversion am Menschen wurde 1947 von Beck, Pritchard und Feil bei anhaltender ventrikulärer Tachykardie angewandt (6). In der Folge wurde die Indikation auch auf die Wiederherstellung des Sinusrhythmus bei Vorhofflimmern ausgeweitet. Problematisch war bei der zunächst üblichen Wechselstrom-Defibrillation (AC = amplitude current) das häufige Auftreten von Kammerflimmern. 1966 zeigte der Vergleich von Nachlas et al. (32) die Überlegenheit des sehr viel kürzeren Gleichstromimpulses (DC = direct current) bei der Kardioversion und Defibrillation. Ein weiterer Sicherheitsfaktor wurde 1962 von Lown et al. mit der Synchronisation des abgegebenen Stromimpulses an der R-Zacke erreicht (29) (Abb. 1). Eine zufällige Kardioversion im Bereich der vulnerablen Phase des Ventrikels konnte so vermieden werden. Insbesondere niedrige Kardioversionsenergien waren ansonsten in der Lage Kammerflimmern auszulösen. Die heutigen Geräte zur Kardioversion (synchronisiert) und Defibrillation (unsynchronisiert) arbeiten alle mit einem Gleichstromimpuls und haben die Möglichkeit der Synchronisation (Abb. 2).

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Authors and Affiliations

  1. Medizinische Klinik I, Stadtkrankenhaus Hanau, Deutschland

    Dr. med. W. A. Fach & H.-J. Becker

  2. Medizinische Klinik I, Stadtkrankenhaus Hanau, Akadem. Lehrkrankenhaus, Johann Wolfgang Goethe-Universität Frankfurt/M., Leimenstr. 20, 63450, Hanau, Deutschland

    Dr. med. W. A. Fach

  3. Institut für Anästhesiologie und operative Intensivmedizin, Stadtkrankenhaus Hanau, Deutschland

    H. Heuberger

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  1. Medizinische Klinik, Klinikum Innenstadt, Ludwig-Maximilians-Universität München, Ziemssenstr. 1, 80336, München, Deutschland

    Michael Scheininger  & Karl Theisen  & 

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© 1994 Dr. Dietrich Steinkopff Verlag, GmbH & Co. KG, Darmstadt

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Fach, W.A., Heuberger, H., Becker, HJ. (1994). Elektrische Therapie von Vorhofflimmern und Vorhofflattern. In: Scheininger, M., Theisen, K. (eds) Vorhofflimmern. Steinkopff. https://doi.org/10.1007/978-3-642-93677-7_8

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  • DOI: https://doi.org/10.1007/978-3-642-93677-7_8

  • Publisher Name: Steinkopff

  • Print ISBN: 978-3-7985-0943-6

  • Online ISBN: 978-3-642-93677-7

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