Herzschrittmachertherapie und Elektrophysiologie最新文献

{"title":"[The EHRA/HRS/APHRS/LAHRS/AEPC consensus statement on the management of atrial tachycardias : Implications of the SMART-AT 10-point plan for clinical practice and healthcare structures].","authors":"Ann-Kathrin Kahle, Fares-Alexander Alken, Christoph Stellbrink, Stefan Perings, Lars Eckardt, Nikolaos Dagres, Christian Veltmann, Philipp Sommer, K R Julian Chun, Anja Schade, Shaojie Chen, Christian Perings, Maura M Zylla, Isabel Deisenhofer, Daniel Steven, Thomas Rostock, Stephan Willems, Christian Meyer","doi":"10.1007/s00399-026-01148-3","DOIUrl":"10.1007/s00399-026-01148-3","url":null,"abstract":"<p><p>Atrial tachycardias (AT) represent an increasingly common cause of morbidity and mortality. Driven by substantial advances in mapping and ablation technologies, the mechanistic understanding and therapeutic strategies for AT management have evolved rapidly in recent years, and catheter ablation is now regarded as the most effective strategy for maintaining sinus rhythm. Against this background, the recently published international clinical consensus statement on the management of patients with AT introduces, for the first time, a structured 10-point plan for \"SMART-AT care\" as a framework for the diagnosis and treatment of regular AT. This review highlights key developments and clinical implications, taking into account recent changes within the healthcare system.</p>","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"217-228"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Management of complications associated with cardiac device procedures].","authors":"Yuriy Hrytsyna, Gaik Nersesian, Christoph Starck","doi":"10.1007/s00399-026-01150-9","DOIUrl":"10.1007/s00399-026-01150-9","url":null,"abstract":"<p><p>Despite declining complication rates, the implantation of cardiac implantable electronic devices (CIEDs) remains a procedure with a significant risk of peri- and postoperative complications. In CIED implantation, acute complications must be taken into account, and their occurrence can be minimized through a standardized, evidence-based approach. However, complications that develop over a longer period of time are more difficult to detect and treat. A particular challenge in this context is the evaluation of suspected CIED infection. This article provides a practice-oriented overview of how to recognize, correctly manage, and prevent complications associated with cardiac device procedures.</p>","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"168-177"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Annual report 2023 of the German Pacemaker and Defibrillator Register-Part 1: Cardiac pacemaker].","authors":"Heiko Burger, Bernd Nowak, Uwe Wiegand, Carsten Israel, Bernd Lemke, Christof Kolb, Andreas Hain, Andreas Markewitz","doi":"10.1007/s00399-026-01137-6","DOIUrl":"10.1007/s00399-026-01137-6","url":null,"abstract":"","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"178-194"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Catheter ablation-induced esophageal complications].","authors":"Philipp Halbfaß, Christian Meinhardt","doi":"10.1007/s00399-026-01141-w","DOIUrl":"10.1007/s00399-026-01141-w","url":null,"abstract":"<p><p>Catheter ablation-induced atrioesophageal fistula (AEF) is one of the most devastating complications of catheter ablation in atrial fibrillation patients and is associated with extraordinarily high morbidity and mortality. Mucosal ulceration, erosion and erythema are milder variants of esophageal injury. Esophageal ulceration is an indicator for increased risk of progression to AEF. In case of clinical suspicion of esophageal perforation with or without fistula a computed tomography with contrast-medium is obligatory to exclude a cardiac fistula before performing esophageal endoscopy. Published strategies to prevent esophageal injury are the use of esophageal temperature probes, mechanical esophagus deviating devices and active esophageal cooling devices. Furthermore, many different strategies were tested to reduce the risk of esophageal injury by modifying ablation techniques and RF ablation parameters in order to limit ablation lesion depth at left atrial posterior wall.Confirmation of an AEF requires urgent cardiac surgery. A conservative or endoscopic approach without surgical intervention is associated with excessively high mortality in case of AEF according to current literature.In case of esophageal perforation without fistula different endoscopic strategies or conservative approaches in combination with a high vigilance for potential progression to fistula have been suggested.A timely, multi-disciplinary and consequently performed standard approach is crucial for a successful management of clinically relevant ablation-induced esophageal complications including esophageal perforation and AEF.The risk of AEF after atrial fibrillation ablation using pulsed field ablation (PFA) techniques seems to be extremely low. Histological esophageal alterations after PFA ablation at left atrial posterior wall have been recently described in an animal experimental study. However, despite the fact that no case of AEF after PFA has been published so far, every new PFA ablation catheter and PFA ablation protocol should also be tested for safety regarding potential esophageal injury.</p>","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"125-138"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare complications in electrophysiological procedures.","authors":"Roman Michalski, Zoe Vogel, Carmen Kolokowsky, Arash Arya","doi":"10.1007/s00399-026-01146-5","DOIUrl":"10.1007/s00399-026-01146-5","url":null,"abstract":"<p><p>Catheter-based electrophysiological procedures are highly effective and generally considered safe. Although common complications are well described and managed according to standardized protocols, rare complications remain incompletely characterized despite their potential for severe morbidity and mortality. This review provides an overview of rare yet clinically relevant complications following electrophysiological ablation procedures, focusing on clinical presentation, diagnostic challenges, and principles of management and prevention. Rare complications are defined as those with a low incidence or those predominantly reported in case reports and small series, despite their clinical impact. The spectrum includes myocardial, valvular, vascular, and coronary injuries associated with radiofrequency and pulsed-field ablation; extracardiac and access-related bleeding; pulmonary and pleural complications; esophageal and left atrial injuries; as well as thromboembolic and hematological events. Emphasis is placed on atypical or delayed symptom presentation and the resulting diagnostic pitfalls. A mechanistic classification is proposed to support early recognition, targeted diagnostic work-up, and timely intervention. Increased clinical awareness, early use of advanced imaging, and interdisciplinary management are essential to improve patient outcomes. Systematic reporting and large-scale registries are crucial to better define incidence, risk factors, and long-term implications, particularly in the context of emerging ablation technologies.</p>","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"157-167"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum zu: Vorhofflattern: vom EKG zur Katheterablation.","authors":"Marcus Wieczorek, Reinhard Hoeltgen","doi":"10.1007/s00399-026-01142-9","DOIUrl":"10.1007/s00399-026-01142-9","url":null,"abstract":"","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"268"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Risk of stroke during left atrial catheter ablation for atrial fibrillation].","authors":"Karl Georg Häusler","doi":"10.1007/s00399-026-01144-7","DOIUrl":"10.1007/s00399-026-01144-7","url":null,"abstract":"<p><p>Periprocedural stroke is one of the most relevant complications of left atrial catheter ablation for atrial fibrillation. Procedure-specific and patient-specific factors as well as the experience of the interventionalists and the intervening center are relevant for the risk of periprocedural stroke. In recent years, the risk of periprocedural stroke has been reduced to less than 0.5% in specialized centers, due to technical advances and the interdisciplinary implementation of magnetic resonance imaging (MRI)-based studies on the risk of procedure-associated cerebral embolism. In addition to appropriate awareness, a standard operating procedure (SOP) is particularly important for the treatment of periprocedural and postprocedural stroke. The SOP should include preventive strategies to avoid stroke, periprocedural blood pressure management, peri- and postprocedural anticoagulation and potential antagonists in cases of (intracranial) bleeding. Furthermore, the SOP should outline further intrahospital treatment pathways. In the event of acute ischemic stroke the possibility of systemic thrombolysis should be evaluated within 4.5 h of symptom onset in cases of a clinically relevant neurological deficit, based on an individual risk-benefit assessment and taking present guideline recommendations as well as product-specific information provided by the manufacturer into account. If an acute proximal occlusion of a brain-supplying artery as well as corresponding clinical symptoms are present, catheter-based (\"mechanical\") recanalization is indicated within a time window of up to 24 h after (possible) onset of symptoms as this can be performed independently of anticoagulant medication. Notably, no randomized studies on the efficacy and safety of these treatments aimed at recanalization in periprocedural stroke are available to date. Based on a selective literature review and own preliminary work, this review article aims to provide recommendations on the prevention and acute treatment of periprocedural stroke.</p>","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"151-156"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Management of pericardial tamponade in the electrophysiology laboratory].","authors":"Laura Rottner","doi":"10.1007/s00399-026-01147-4","DOIUrl":"10.1007/s00399-026-01147-4","url":null,"abstract":"<p><p>Catheter ablation is an established treatment method for various types of cardiac arrhythmias and generally exhibits a high success rate and an excellent safety profile. However, despite increasing experience and improved ablation strategies and technologies, potentially life-threatening complications can occur. Pericardial tamponade is the most common serious complication in electrophysiological interventions and requires immediate, coordinated, and effective treatment. The following article summarized the incidence, risk factors, and potential causes of peri-interventional pericardial effusion or tamponade during electrophysiological interventions and discusses strategies for prevention and complication management.</p>","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"120-124"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supraventricular tachycardias in ion channel diseases.","authors":"Christian Wolpert, Gaetano Vacanti, Davit Ohanyan, Norman Rüb","doi":"10.1007/s00399-025-01127-0","DOIUrl":"10.1007/s00399-025-01127-0","url":null,"abstract":"<p><p>Supraventricular tachyarrhythmias are a clinical finding that is seen to a varying extent in patients with ion channel diseases depending on the underlying genetic disease. In addition to the classical symptoms that they cause, they may trigger ventricular tachyarrhythmias or induce inappropriate implantable cardioverter-defibrillator (ICD) therapies and, thus, cause psychological harm. Antiarrhythmic drugs can be used in some diseases, but are contraindicated in a number of genetic conditions. In these patients, catheter ablation is a good alternative and sometimes the only treatment choice. In young individuals with atrial fibrillation, ion channel diseases should be excluded, especially when there is familial disease or early onset of atrial fibrillation, in particular below 30 years of age.</p>","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"35-41"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitteilungen aus der Arbeitsgruppe Elektrophysiologie und Rhythmologie (AGEP).","authors":"","doi":"10.1007/s00399-026-01132-x","DOIUrl":"10.1007/s00399-026-01132-x","url":null,"abstract":"","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"116"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146088070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}