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Herzrhythmusstörungen mit Wearables erkennen und neue Abalationsverfahren

February 27, 2026·25 min·2 clips

One in three people over 55 will develop atrial fibrillation, yet many don't know what symptoms to look for.

1. Ne Dosis Wissen special episode, hosted by Dr. Laura Weißenburger, covers cardiac arrhythmia detection and new ablation techniques ahead of Pulse Day on February 27. 2. Guest Dr. Melanie Gunnar-Vardine is an electrophysiologist and arrhythmia researcher at the Cardio-Oncological Centre Bethanien Frankfurt, specializing in catheter ablation and atrial fibrillation. 3. The episode's core thesis is that wearable devices and pulsed-field ablation together represent a transformation in how arrhythmias are caught and treated, from long diagnostic delays to rapid, minimally invasive therapy. 4. Dr. Gunnar-Vardine cites a lifetime atrial fibrillation risk above 30% for Europeans over age 55, meaning one in three will develop the condition. 5. She explains the rationale for Pulse Day: no existing annual awareness day addressed cardiac arrhythmias specifically, despite widespread confusion between arrhythmias and heart attacks. 6. Wearable EKG quality is described as 'very good' when reviewed by a cardiologist, but she cautions that the algorithms delivering user-facing alerts are not always accurate and can produce artefacts. 7. Dr. Gunnar-Vardine recommends that patients with symptomatic arrhythmias—especially those occurring once a month or nocturnally—may benefit from wearables when standard 24-hour Holter monitoring is unlikely to capture an episode. 8. She notes that wearable costs are not covered by statutory health insurance in most cases, so the recommendation must be individualized and financially transparent. 9. She describes a cardiologist colleague who detected his own AV node re-entry tachycardia via wearable when his heart rate reached 230 bpm during exercise; ablation achieved over 90% success and he returned to cycling within ten days. 10. Catheter ablation has shifted to first-line therapy for symptomatic atrial fibrillation in current guidelines because it reduces arrhythmia burden and improves quality of life more effectively than antiarrhythmic drugs. 11. Randomized data show catheter ablation outperforms antiarrhythmic medication in reducing atrial fibrillation load and delivers prognostic benefits for certain patient cohorts. 12. Pulsed-field ablation (PFA) works through electroporation—delivering short high-energy electrical fields that create pores in cardiomyocyte membranes, causing cell death at lower field strengths than surrounding tissue like the esophagus or phrenic nerve. 13. The thermal independence of PFA reduces collateral damage risk compared to radiofrequency or cryoablation, though catheter-associated complications such as pericardial tamponade remain possible with all energy modalities. 14. Current randomized data comparing PFA with thermal ablation have not yet demonstrated clear superiority of PFA in all studies, so all techniques remain in use. 15. PFA is described as easier to learn and more operator-independent than thermal techniques, with shorter procedure and sedation times benefiting patients. 16. Dr. Gunnar-Vardine notes that for patients with additional arrhythmia substrates beyond pulmonary vein isolation, thermal techniques may still be preferable due to the anatomical constraints of current PFA catheter designs. 17. She identifies AI-assisted high-resolution mapping as an active research area to better locate the sources of atrial fibrillation within the atrium. 18. The tone is collegial and accessible: Laura Weißenburger positions herself as a medical professional but not a specialist, asking clarifying questions that serve non-electrophysiologist listeners. 19. Cardiologists, general practitioners, and healthcare professionals who routinely encounter patients with wearable-detected arrhythmias will find the practical diagnostic and referral guidance directly applicable. 20. Listeners outside the German-speaking healthcare system or those seeking patient-facing lay explanations rather than clinical guidance will find limited direct utility.

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