Rhythmogene Synkopen - Wann sind sie prognostisch unbedeutend, wann lebensbedrohlich? - Auslöser sind brachykarde oder tachykarde Herzrhythmusstörungen

Cardiac arrhythmias are the second most frequent cause of syncope in clinical practice. Depending on the type and rate of the arrhythmia as well as on the disease state of the patient bradyarrhythmias as well as tachyarrhythmias can lead to a low-output-syndrome, cerebral hypoperfusion and finally transient loss of consciousness. Their sporadic occurrence and the missing ECG documentation of the arrhythmia during syncope make the diagnosis often difficult, but important since syncopal events can present as prodromi of life-threatening ventricular arrhythmias. The therapy of cardiac arrhythmias is guided by the type and severity of the symptomatic arrhythmia and aims at prevention of sudden cardiac death, recurrence of syncope and improvement in quality of life. Besides the usage of pharmacological therapies, catheter ablation for supraventricular tachycardias and pacemaker therapy in patients with bradyarrhythmias as well as the implantation of the cardioverter/defibrillator are currently available therapy options in patients with ventricular arrhythmias as the primary cause of syncope.