Artikel ; Online: Unifocal Right-Sided Ablation Treatment for Neurally Mediated Syncope and Functional Sinus Node Dysfunction Under Computed Tomographic Guidance.
Circulation. Arrhythmia and electrophysiology
2018 Band 11, Heft 9, Seite(n) e006604
Abstract: Background Biatrial, extensive, and complex ablation strategies have been published for the treatment of neurally mediated syncope, sinus node dysfunction, and functional atrioventricular block. We have developed a less extensive and more specific ... ...
| Abstract | Background Biatrial, extensive, and complex ablation strategies have been published for the treatment of neurally mediated syncope, sinus node dysfunction, and functional atrioventricular block. We have developed a less extensive and more specific approach compared with previously published cardioneuroablation strategies, called cardio-neuromodulation. It is based on tailored vagolysis of the sinoatrial node through partial ablation of the anterior right-ganglionated plexus, preferentially through a right-sided approach. Methods Patients with syncope were enrolled between December 2016 and December 2017. They were assigned to group A if they had a positive head-up tilt test and to group B if they presented with a pause ≥3 seconds. The area to target during cardio-neuromodulation was designed offline on a computed tomographic scan. Slow heart rates and pauses were compared during 24-hour rhythm registration at baseline, at 1-month follow-up, and 6-month follow-up. Syncope burden was assessed before the procedure and at 3- and 6-month follow-up. Results Twenty patients underwent cardio-neuromodulation through a right-sided approach (12 in group A, 8 in group B). The first application of radiofrequency energy led to a P-P interval shortening >120 ms in all 20 patients. After a mean±SD ablation time of 7±4 minutes and mean ablated surface area of 11±6 mm |
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| Mesh-Begriff(e) | Action Potentials ; Adult ; Aged ; Belgium ; Bradycardia/etiology ; Bradycardia/physiopathology ; Catheter Ablation/adverse effects ; Catheter Ablation/methods ; Electrocardiography, Ambulatory ; Female ; Heart Rate ; Humans ; Male ; Middle Aged ; Prospective Studies ; Radiography, Interventional/methods ; Recurrence ; Sick Sinus Syndrome/complications ; Sick Sinus Syndrome/diagnosis ; Sick Sinus Syndrome/physiopathology ; Sick Sinus Syndrome/surgery ; Syncope, Vasovagal/diagnosis ; Syncope, Vasovagal/etiology ; Syncope, Vasovagal/physiopathology ; Tilt-Table Test ; Time Factors ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult |
| Sprache | Englisch |
| Erscheinungsdatum | 2018-10-25 |
| Erscheinungsland | United States |
| Dokumenttyp | Clinical Trial, Phase II ; Journal Article ; Research Support, Non-U.S. Gov't |
| ZDB-ID | 2426129-4 |
| ISSN | 1941-3084 ; 1941-3149 |
| ISSN (online) | 1941-3084 |
| ISSN | 1941-3149 |
| DOI | 10.1161/CIRCEP.118.006604 |
| Datenquelle | MEDical Literature Analysis and Retrieval System OnLINE |
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