Lüderitz B
Medizinische Klinik und Poliklink II Universitätsklinikum Bonn Sigmund-Freud-Str. 25 D-53105 Bonn.
Z Kardiol. 2002;91 Suppl 4:50-5. doi: 10.1007/s00392-002-1408-8.
The history of cardiac rhythm disorders including antiarrhythmic drugs and electrotherapeutical tools is long and fascinating. In the beginning, there was not simply the anatomy and physiology of the heart, but also analysis of the pulse, which indicates the activity of the heart. Thus, like any other field of medicine, the study of arrhythmias has a distinctive past. Our current level of knowledge is not the result of a straight, linear progression any more than there is a static, established, monolithic body of thought dominating this field. Instead, our knowledge of arrhythmias today is the result of many competitive, sometimes serendipitous, scientific realizations, of which a few proved useful enough to pursue and eventually led to real advancements. Looking at the worldwide development of rhythmology it can be said that considerable contributions came from Germany in the last few centuries. Arrhythmology--past, present and future--includes clearly German investigators as pioneers of the field. The growing clinical importance of electric cardiac stimulation has been recognized and renewed as Zoll in 1952 described a successful resuscitation in cardiac standstill by external stimulation. The concept of a fully automatic implantable cardioverter-defibrillator system for recognition and treatment of ventricular flutter/fibrillation was first suggested in 1970. The first implantation of the device in a human being was performed in February 1980. By early 1997, 17 years after the first human implantation more than 100,000 ICD systems had been implanted worldwide. Further developments concern new pharmacological compounds, modern cardioverter-defibrillators, radiofrequency ablation, particularly pulmonary vein ablation in atrial fibrillation, innovative pacemakers including preventive pacing techniques, probably laser therapy and perhaps the automatic implantable pharmacological defibrillator. The advances in the field of therapeutic application of pharmacologic and electrical means as well as alternative methods will continue as rapidly as before in order to give us further significant aid in taking care of the patient.
心律失常的历史，包括抗心律失常药物和电治疗工具，漫长而引人入胜。起初，不仅有心脏的解剖学和生理学，还有对脉搏的分析，脉搏反映了心脏的活动。因此，与医学的任何其他领域一样，心律失常的研究有着独特的过去。我们目前的知识水平并非直线式线性发展的结果，也不存在一个静态、既定、统一的思想体系主导这一领域。相反，我们如今对心律失常的认识是许多竞争性的、有时是偶然的科学发现的结果，其中一些发现被证明足够有用而得以深入研究，并最终带来了真正的进步。从全球心律学的发展来看，可以说过去几个世纪德国做出了相当大的贡献。心律学——过去、现在和未来——显然都有德国研究者作为该领域的先驱。随着1952年佐尔描述了通过外部刺激成功复苏心脏停搏，心脏电刺激在临床上日益增长的重要性得到了认可并得以复兴。1970年首次提出了用于识别和治疗室性心动过速/心室颤动的全自动植入式心脏复律除颤器系统的概念。1980年2月首次在人体植入该设备。到1997年初，即首次人体植入后的17年，全球已植入超过10万台植入式心脏复律除颤器系统。进一步的发展涉及新的药物化合物、现代心脏复律除颤器、射频消融，特别是房颤的肺静脉消融、包括预防性起搏技术在内的创新型起搏器、可能的激光治疗以及或许还有自动植入式药物除颤器。药理学和电学手段以及替代方法在治疗应用领域的进展将继续像以前一样迅速，以便在照顾患者方面给予我们进一步的重大帮助。
