Heart report | Therapy success also in the hands of the patient

Many cardiac arrhythmias only occur during physical exertion, while a normal resting ECG remains normal. Photo: IMAGO/BSIP The heart is restless – and keeps us alive. It beats. The frequency is variable - among other things, it depends on external events. Our pump has its own electrical system, a stimulus conduction system. If this is okay, the heart muscle contracts rhythmically, coordinated and as needed to pump blood through the body. This body's own clock runs without conscious control from the brain. But he can also stammer. The most common cardiac arrhythmia worldwide is atrial fibrillation (AF). The impulses in the atria of the heart are chaotic, noticeable in an irregular and rapid pulse, which increases the risk of stroke.

It is precisely this atrial fibrillation that is the focus of the latest edition of the German Heart Report. This year's update, published by the German Heart Foundation, was presented in Berlin on Wednesday. The arrhythmia mentioned is one of the five major diseases relating to the heart that occur most frequently and account for the largest share of cardiac medical care. They are also at the forefront when it comes to mortality - just as cardiovascular diseases lead the ranking of causes of death in Germany. Cancer continues to follow in second place.

One in three strokes is related to atrial fibrillation.

In Germany, 1.6 million people lived with atrial fibrillation in 2024. It is directly responsible for “only” 30,000 deaths per year. But every third stroke is also related to AF, as Thomas Voigtländer explains. The chairman of the board of the German Heart Foundation works as a cardiologist in Frankfurt am Main. »The atrial fibrillation comes from the left atrium. To be more precise, blood clots form there, in the left atrial appendage, because the heart no longer beats properly," says the doctor.

Each year, 360,000 cases of AF are treated in hospitals, but only 5,900 people undergo rehabilitation for this reason alone. For many other rehabilitation patients, AF was just one of several serious symptoms. According to Eike Langheim from the Society for the Prevention and Rehabilitation of Cardiovascular Diseases, risk factors such as high blood pressure and obesity can also be easily addressed in rehab. “If you succeed in establishing physical training, there will be fewer recurrences,” i.e. relapses in the disease being treated. Langheim points out that, according to renewed European treatment guidelines, rehabilitation measures for VFL are a must. Because there are not enough such places in Germany, the patients should be carefully selected. So it's about those who can't manage an exercise program or a change in diet on their own.

Before rehab, however, comes therapy. In AF, so-called ablations are currently increasing rapidly in number. The starting points of electrical spurious impulses in the heart tissue are destroyed by heat, cold or electricity. As a result, tiny scar tissue develops there that can no longer transmit the wrong impulses. 95 percent of these interventions are carried out using a catheter, i.e. a minimally invasive procedure.

Because so-called hybrid DRGs have been introduced this year, there will also be a trend towards more outpatient care in cardiac medicine. According to Voigtländer, this will particularly affect catheter ablations for cardiac arrhythmias, but also stent treatment for patients with coronary heart disease, pacemaker therapies or the implantation of a defibrillator.

One of the important therapeutic elements for AF is blood thinning with the help of medication. You can also try to slow down the pulse with medication, for example with beta blockers. It is particularly important for all patients with the symptoms to keep an eye on the main risk factors: blood pressure should be well controlled and excess weight should be lost. This also includes largely avoiding alcohol and tobacco and getting enough exercise.

An important classification on this topic comes when presenting a patient's heart report. Emil Walla, now 45, has been suffering from irregularities in his “pump” for some time. In the pandemic year of 2022, he fell ill with Covid-19 in February and then with severe flu in December. He was getting worse and worse; one morning he could no longer climb the stairs to the office. Despite blood thinners and medication to relieve the pressure on his heart, he experienced increasingly frequent and longer attacks of AF. Even a first ablation was only initially successful - a story shared by many patients with this type of procedure. After the second ablation in June 2026, he is now doing well: "I am in sinus rhythm," says Walla with relief, and by this he means the normal and healthy human heartbeat, whose impulse comes from the sinus node in the right atrium of the heart.

But Walla adds: “It was also hard work.” Because after the first ablation was not lastingly successful, he realized that he had not contributed anything to the therapy other than taking medication and completing the appointments. Then he started to get some exercise on his bike every day after the office instead of staying on the sofa. He has lost 20 kilograms since the beginning of the year and says today: "50 percent of the success of the treatment is in the patient's own hands."

The »nd.Genossenschaft« belongs to its readers and authors. They are the ones who make our journalism accessible to everyone through their contribution: We are not backed by a media company, not a large advertising customer or even a billionaire.

Thanks to the support of our community we can:

→ report independently and critically → shine a light on topics that otherwise remain in the shadows → give space to voices that are often silenced → counter disinformation with facts → strengthen and deepen left-wing perspectives

With “Voluntarily pay” you contribute to the financing of our newspaper in solidarity. So that nd remains.