Durable Physiological Changes and Decreased Syncope Burden 12 Months After Unifocal Right-Sided Ablation Under Computed Tomographic Guidance in Patients With Neurally Mediated Syncope or Functional Sinus Node Dysfunction
Philippe Debruyne, Tom Rossenbacker, Luc Janssens, Christine Collienne, Joris Ector, Peter Haemers, Jean-Benoît le Polain de Waroux, Christine Bazelmans, Tim Boussy, William Wijns, Philippe Debruyne, Tom Rossenbacker, Luc Janssens, Christine Collienne, Joris Ector, Peter Haemers, Jean-Benoît le Polain de Waroux, Christine Bazelmans, Tim Boussy, William Wijns
Abstract
[Figure: see text].
Trial registration: ClinicalTrials.gov NCT02954666.
Keywords: autonomic nervous system; cohort studies; exercise test; heart rate; syncope.
Figures
References
- Shen WK, Sheldon RS, Benditt DG, Cohen MI, Forman DE, Goldberger ZD, Grubb BP, Hamdan MH, Krahn AD, Link MS, et al. . 2017 ACC/AHA/HRS guideline for the evaluation and management of patients with syncope: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2017;136:e25–e59. doi: 10.1161/CIR.0000000000000498
- Brignole M, Moya A, de Lange FJ, Deharo JC, Elliott PM, Fanciulli A, Fedorowski A, Furlan R, Kenny RA, Martin A, et al. . 2018 ESC Guidelines for the diagnosis and management of syncope. Eur Heart J. 2018;39:1883–1948.
- Pachon JC, Pachon EI, Pachon JC, Lobo TJ, Pachon MZ, Vargas RN, Jatene AD. “Cardioneuroablation”–new treatment for neurocardiogenic syncope, functional AV block and sinus dysfunction using catheter RF-ablation. Europace. 2005;7:1–13. doi: 10.1016/j.eupc.2004.10.003
- Pachon JC, Pachon EI, Cunha Pachon MZ, Lobo TJ, Pachon JC, Santillana TG. Catheter ablation of severe neurally meditated reflex (neurocardiogenic or vasovagal) syncope: cardioneuroablation long-term results. Europace. 2011;13:1231–1242. doi: 10.1093/europace/eur163
- Yao Y, Shi R, Wong T, Zheng L, Chen W, Yang L, Huang W, Bao J, Zhang S. Endocardial autonomic denervation of the left atrium to treat vasovagal syncope: an early experience in humans. Circ Arrhythm Electrophysiol. 2012;5:279–286. doi: 10.1161/CIRCEP.111.966465
- Aksu T, Golcuk E, Yalin K, Guler TE, Erden I. Simplified crdioneuroablation in the treatment of reflex syncope, functional AV block, and sinus node dysfunction. Pacing Clin Electrophysiol. 2016;39:42–53.
- Sun W, Zheng L, Qiao Y, Shi R, Hou B, Wu L, Guo J, Zhang S, Yao Y. Catheter ablation as a treatment for vasovagal syncope: long-term outcome of endocardial autonomic modification of the left atrium. J Am Heart Assoc. 2016;5:e003471.
- Rivarola EW, Hachul D, Wu T, Pisani C, Hardy C, Raimundi F, Melo S, Darrieux F, Scanavacca M. Targets and end points in cardiac autonomic denervation procedures. Circ Arrhythm Electrophysiol. 2017;10:e004638. doi: 10.1161/CIRCEP.116.004638
- Hu F, Zheng L, Liang E, Ding L, Wu L, Chen G, Fan X, Yao Y. Right anterior ganglionated plexus: the primary target of cardioneuroablation? Heart Rhythm. 2019;16:1545–1551. doi: 10.1016/j.hrthm.2019.07.018
- Zhao L, Jiang W, Zhou L, Wang Y, Zhang X, Wu S, Xu K, Liu X. Atrial autonomic denervation for the treatment of long-standing symptomatic sinus bradycardia in non-elderly patients. J Interv Card Electrophysiol. 2015;43:151–159. doi: 10.1007/s10840-015-9981-8
- Qin M, Zhang Y, Liu X, Jiang WF, Wu SH, Po S. Atrial ganglionated plexus modification: a novel approach to treat symptomatic sinus bradycardia. JACC Clin Electrophysiol. 2017;3:950–959. doi: 10.1016/j.jacep.2017.01.022
- Aksu T, Guler TE, Bozyel S, Golcuk SE, Yalin K, Lakkireddy D, Gopinathannair R. Medium-term results of cardioneuroablation for clinical bradyarrhythmias and vasovagal syncope: effects on QT interval and heart rate. J Interv Card Electrophysiol. 2021;60:57–68. doi: 10.1007/s10840-020-00704-2
- Debruyne P. “Cardio-neuromodulation” with a multielectrode irrigated catheter: a potential new approach for patients with cardio-inhibitory syncope. J Cardiovasc Electrophysiol. 2016;27:1110–1113.
- Debruyne P, Wijns W. Cardio-neuromodulation: the right-sided approach. JACC Clin Electrophysiol. 2017;3:1056–1057. doi: 10.1016/j.jacep.2016.12.027
- Debruyne P, Rossenbacker T, Collienne C, Roosen J, Ector B, Janssens L, Charlier F, Vankelecom B, Dewilde W, Wijns W. Unifocal right-sided ablation treatment for neurally mediated syncope and functional sinus node dysfunction under computed tomographic guidance. Circ Arrhythm Electrophysiol. 2018;11:e006604. doi: 10.1161/CIRCEP.118.006604
- Hanna P, Rajendran PS, Ajijola OA, Vaseghi M, Andrew Armour J, Ardell JL, Shivkumar K. Cardiac neuroanatomy - Imaging nerves to define functional control. Auton Neurosci. 2017;207:48–58. doi: 10.1016/j.autneu.2017.07.008
- Brignole M, Menozzi C, Del Rosso A, Costa S, Gaggioli G, Bottoni N, Bartoli P, Sutton R. New classification of haemodynamics of vasovagal syncope: beyond the VASIS classification. Analysis of the pre-syncopal phase of the tilt test without and with nitroglycerin challenge. Vasovagal Syncope International Study. Europace. 2000;2:66–76. doi: 10.1053/eupc.1999.0064
- Zaglia T, Mongillo M. Cardiac sympathetic innervation, from a different point of (re)view. J Physiol. 2017;595:3919–3930. doi: 10.1113/JP273120
- Grinsell D, Keating CP. Peripheral nerve reconstruction after injury: a review of clinical and experimental therapies. Biomed Res Int. 2014;2014:698256. doi: 10.1155/2014/698256
- Hou Y, Scherlag BJ, Lin J, Zhang Y, Lu Z, Truong K, Patterson E, Lazzara R, Jackman WM, Po SS. Ganglionated plexi modulate extrinsic cardiac autonomic nerve input: effects on sinus rate, atrioventricular conduction, refractoriness, and inducibility of atrial fibrillation. J Am Coll Cardiol. 2007;50:61–68. doi: 10.1016/j.jacc.2007.02.066
- Debruyne P. Letter by Debruyne Regarding Article, “Targets and end points in cardiac autonomic denervation procedures”. Circ Arrhythm Electrophysiol. 2017;10:e005261.
Source: PubMed