When the young heart stops
Cardiology(21.06.2016) Again and again, young, seemingly healthy people suddenly suffer serious cardiac arrhythmias - often with fatal outcomes. Experts estimate that around 50,000 - 100,000 people in Germany are at risk of hereditary cardiac arrhythmias.
But many are unaware of the danger: "Those affected often only find out about their risk when they themselves or a parent survive a serious cardiac arrhythmia," says Professor Dr. Katja Odening. The cardiologist at the Department of Cardiology and Angiology I at the University Heart Center Freiburg - Bad Krozingen (Director: Prof. Dr. Dr. h.c. Christoph Bode) heads the "Special Outpatient Clinic for Congenital Arrhythmogenic Diseases", which was established in 2012.
Depending on the underlying disease, different factors trigger such a cardiac arrhythmia. "Work stress, competitive sport and even being woken up by an alarm clock can lead to a life-threatening situation," says Professor Odening. Hormonal status can also play a role in certain diseases. In the case of long QT syndrome, for example, boys are particularly at risk of potentially fatal arrhythmias before puberty, while girls are only at high risk during or after puberty. This is because the female hormone oestrogen promotes arrhythmias, while testosterone tends to have an inhibitory effect, as the researchers led by Professor Odening were able to demonstrate. In some cases, antibiotics and other medications also increase the risk.
If a patient survives a severe cardiac arrhythmia, also known as ventricular fibrillation, the doctors in the special outpatient clinic examine them and their relatives for hereditary causes of the arrhythmia. The most important tool for this is the electrocardiogram (ECG), which records heart activity: the heart rate is measured at rest, under stress while cycling and over a period of 24 hours.
For some time now, complex genetic analyses have also been part of standard diagnostics at the University Heart Center Freiburg - Bad Krozingen. "In addition, we are currently investigating whether changes in the electrical or mechanical properties of the heart provide further indications of the risk of arrhythmia in these congenital diseases," says the cardiologist.
The treatment depends precisely on the disease in question. An important part of treatment is for patients to avoid potential triggers specific to their condition, such as competitive sport, physical stress, fever or excessive alcohol. In certain cases, medications such as certain antibiotics are also taboo. Regular cardiological checks should indicate a deterioration in the situation at an early stage.
If such preventive measures are not sufficient, implantation of a defibrillator, which stops ventricular fibrillation by means of a brief electrical shock, often helps. In addition, beta blockers were previously considered to be very effective drugs against arrhythmia in some congenital rhythm disorders. However, as the latest research results show, these are only effective enough for some of those affected, depending on their genetic profile. Cardiologist Professor Odening and her team are therefore looking for alternatives, for example in gender-specific therapy for hormone-controlled heart rhythm disorders. "We examine which diagnostics could be valuable for each patient individually and tailor the treatment plan accordingly," says Professor Odening.
People who are suspected of having a congenital heart rhythm disorder can present at the "Outpatient Clinic for Congenital Arrhythmogenic Diseases" at the UHZ.
Contact
Outpatient Clinic for Congenital Arrhythmogenic Diseases
Department of Cardiology and Angiology I
University Heart Center Freiburg - Bad Krozingen
Phone: 0761/270-35480
katja.odening@universitaets-herzzentrum.de
Further information