\tikzsetnextfilename{Asymtomatisches-WPW}

    %\begin{tikzpicture}[node distance=2cm, thick,scale=0.8, every node/.style={scale=0.8}]
    \begin{tikzpicture}[node distance=2cm]

    \node (about) [about, text width=6cm] {\textbf{asymptomatische ventrikuläre Präexzitation}};

    \node (dec1) [decision, aspect=1.5, below of=about, yshift=-1.75cm, xshift=-4cm, text width=5cm] {\textbf{kein} Verlust der Präexzitation*};
    \node (dec2) [decision, aspect=1.5, below of=about, yshift=-1.75cm, xshift=4cm, text width=5cm] {Verlust der Präexzitation*};
    \draw [arrow] (about.west) -| (dec1);
    \draw [arrow] (about.east) -| (dec2);

    \node (therapy1) [therapy, below of=dec1, yshift=-2.0cm, text width=4cm] {elektrophysiologische Untersuchung};
    \draw [arrow] (dec1) -- (therapy1);

    \node (dec3) [decision, aspect=1.5, below of=therapy1, yshift=-1.5cm, text width=4cm] {Hochrisikofaktoren vorhanden**};
    \node (dec4) [decision, aspect=1.5, below of=dec2, yshift=-5.5cm, text width=4cm] {\textbf{keine} Hochrisikofaktoren vorhanden**};
    \draw [arrow] (therapy1) -- (dec3);
    \draw [arrow] (dec2) -- (dec4);
    \draw [arrow] (therapy1) -- (dec4);

    \node (therapy2) [therapy, below of=dec3, yshift=-1.5cm, text width=4cm] {Katheterablation};
    \node (therapy3) [therapy, below of=dec4, yshift=-1.5cm, text width=4cm] {regelmäßige Folgeuntersuchungen};
    \draw [arrow] (dec3) -- (therapy2);
    \draw [arrow] (dec4) -- (therapy3);

    \end{tikzpicture}