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Published on: April 21, 2013
Procedural Characteristics, Safety, and Follow-up of Modified Right-Sided Approach for Cardioneuroablation
Başar Candemir1, Emir Baskovski1, Osman Beton2
1Department of Cardiology, Faculty of Medicine, Ankara University, Ankara, Turkey.
Insights
A right-sided cardioneuroablation effectively treats vasovagal syncope by targeting specific ganglionated plexi. This minimally invasive approach offers a promising default treatment option for patients experiencing recurrent syncope.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- Vasovagal syncope is a common condition often managed with medication or lifestyle changes.
- Cardioneuroablation is an emerging therapy targeting autonomic nervous system dysfunction.
- A right-sided approach to cardioneuroablation offers a simplified technique.
Purpose of the Study:
- To present a simplified right-sided cardioneuroablation technique for vasovagal syncope.
- To evaluate the procedural and follow-up outcomes of this approach.
- To assess the efficacy of targeting anterior-right and right-inferior ganglionated plexi.
Main Methods:
- Radio-anatomically guided radiofrequency ablation targeting specific ganglionated plexi.
- Inclusion of 23 patients with vasovagal syncope from two clinics.
- Assessment of syncope, symptom burden, and 24-hour ambulatory ECG data pre- and post-procedure.
Main Results:
- Significant decrease in basal cycle length (862.3 to 695.8 ms) and increase in 24-hour ambulatory heart rate (66.4 to 80 bpm).
- High procedural success rate with only one patient experiencing a single syncope episode post-ablation.
- Mean follow-up of 10 months showed sustained efficacy and symptom reduction.
Conclusions:
- Right-sided cardioneuroablation is an effective treatment for vasovagal syncope.
- This approach may be considered a default initial therapy for cardioneuroablation.
- The technique demonstrates safety and efficacy in managing vasovagal syncope.
Background:
Cardioneuroablation is one of the emerging therapies in vasovagal syncope. In this study, we present a simple method of cardioneuroablation performed via a rightsided approach, targeting anterior-right and right-inferior ganglionated plexi, along with procedural and follow-up data.
Methods:
Patients who had underwent cardioneuroablation between March 2018 and September 2019 with vasovagal syncope in 2 clinics were enrolled in the study. All patients underwent radio-anatomically guided radiofrequency ablation targeting anterior-right ganglionated plexi and right-inferior ganglionated plexi. Syncope and symptom burden, 24-hour ambulatory electrocardiogram data at presentation, and at follow-up were assessed along with procedural data.
Results:
A total of 23 patients underwent modified right-sided cardioneuroablation. Mean basal cycle length decreased significantly from 862.3 ± 174.5 ms at the beginning of the procedure 695.8 ± 152.1 ms following the final radiofrequency ablation (P < .001). Mean 24-hour ambulatory heart rate increased significantly from 66.4 ± 10.7 bpm at baseline to 80 ± 7.6 bpm at follow-up (P < .001). Only 1 patient had 1 episode of syncope following the procedure at the mean follow-up period of 10 ± 2.9 months. The same patient had recurrent presyncope.
Conclusion:
The right-sided cardioneuroablation approach was found to be an effective treatment for vasovagal syncope and may be regarded as a default initial cardioneuroablation technique.
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