Cardioneuroablation for reflex syncope or functional bradyarrhytmias: new insight from a single center experience
BackgroundCardioneuroablation (CNA) is a new approach to treat reflex syncope and functional bradyarrhytmias caused by autonomic imbalance. We report our experience using CNA.MethodFrom September 2022 to July 2023, we took care of 21 patients (mean age 42 ± 21 years; 62% male) affected by reflex syn...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1526825/full |
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| author | Noemi Valenti Antonio Di Monaco Imma Romanazzi Nicola Vitulano Federica Troisi Federico Quadrini Antonio Vitullo Luca Sgarra Rosa Caruso Vincenzo Anzelmo Pietro Guida Natale Daniele Brunetti Massimo Grimaldi |
| author_facet | Noemi Valenti Antonio Di Monaco Imma Romanazzi Nicola Vitulano Federica Troisi Federico Quadrini Antonio Vitullo Luca Sgarra Rosa Caruso Vincenzo Anzelmo Pietro Guida Natale Daniele Brunetti Massimo Grimaldi |
| author_sort | Noemi Valenti |
| collection | DOAJ |
| description | BackgroundCardioneuroablation (CNA) is a new approach to treat reflex syncope and functional bradyarrhytmias caused by autonomic imbalance. We report our experience using CNA.MethodFrom September 2022 to July 2023, we took care of 21 patients (mean age 42 ± 21 years; 62% male) affected by reflex syncope or functional bradyarrhythmias. All patients underwent CNA under conscious sedation targeting the superior and/or inferior paraseptal ganglionated plexus (GPs).ResultsNine patients were affected by vasovagal syncope (VVS) and twelve by functional bradyarrhythmias. In 3 cases (14%) the ablation was performed only on the GPs of the right atrium, while in the remaining 86% of cases we performed biatrial lesions. As regards the acute results, we highlighted an increase in sinus heart rate (12 ± 15 bpm, p = 0.001), a shortening of the PQ interval (−18 ± 18 msec, p < 0.001), a reduction of the correct sinus node recovery times (cSNRT) (−142 ± 204 msec, p = 0.114), a shortening of the AH interval (−31 ± 26 msec, p = 0.008), a reduction of the effective refractory period of the atrio-ventricular node (−156; interquartile range from −30 to −160 msec, p = 0.042) and an increase in the Wencheback point (27 ± 20 bpm, p < 0.001). At follow-up, a single patient, due to persistent symptoms and bradyarrhythmic disorder, underwent permanent pacemaker implantation; no other patient had recurrence of syncope, and all remained persistently asymptomatic.ConclusionOur results confirm the efficacy and safety of CNA for the treatment of VVS and functional bradyarrhythmias, although further studies are needed to support these findings. |
| format | Article |
| id | doaj-art-1136b30248004f8b973c10bc78ea163e |
| institution | Kabale University |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-1136b30248004f8b973c10bc78ea163e2025-01-31T14:21:01ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-01-011110.3389/fcvm.2024.15268251526825Cardioneuroablation for reflex syncope or functional bradyarrhytmias: new insight from a single center experienceNoemi Valenti0Antonio Di Monaco1Imma Romanazzi2Nicola Vitulano3Federica Troisi4Federico Quadrini5Antonio Vitullo6Luca Sgarra7Rosa Caruso8Vincenzo Anzelmo9Pietro Guida10Natale Daniele Brunetti11Massimo Grimaldi12Department of Cardiology, General Regional Hospital “F. Miulli”, Bari, ItalyDepartment of Cardiology, General Regional Hospital “F. Miulli”, Bari, ItalyDepartment of Cardiology, Hospital “San Paolo”, Bari, ItalyDepartment of Cardiology, General Regional Hospital “F. Miulli”, Bari, ItalyDepartment of Cardiology, General Regional Hospital “F. Miulli”, Bari, ItalyDepartment of Cardiology, General Regional Hospital “F. Miulli”, Bari, ItalyDepartment of Medical and Surgical Sciences, Foggia University, Foggia, ItalyDepartment of Cardiology, General Regional Hospital “F. Miulli”, Bari, ItalyDepartment of Cardiology, General Regional Hospital “F. Miulli”, Bari, ItalyDepartment of Cardiology, General Regional Hospital “F. Miulli”, Bari, ItalyDepartment of Cardiology, General Regional Hospital “F. Miulli”, Bari, ItalyDepartment of Medical and Surgical Sciences, Foggia University, Foggia, ItalyDepartment of Cardiology, General Regional Hospital “F. Miulli”, Bari, ItalyBackgroundCardioneuroablation (CNA) is a new approach to treat reflex syncope and functional bradyarrhytmias caused by autonomic imbalance. We report our experience using CNA.MethodFrom September 2022 to July 2023, we took care of 21 patients (mean age 42 ± 21 years; 62% male) affected by reflex syncope or functional bradyarrhythmias. All patients underwent CNA under conscious sedation targeting the superior and/or inferior paraseptal ganglionated plexus (GPs).ResultsNine patients were affected by vasovagal syncope (VVS) and twelve by functional bradyarrhythmias. In 3 cases (14%) the ablation was performed only on the GPs of the right atrium, while in the remaining 86% of cases we performed biatrial lesions. As regards the acute results, we highlighted an increase in sinus heart rate (12 ± 15 bpm, p = 0.001), a shortening of the PQ interval (−18 ± 18 msec, p < 0.001), a reduction of the correct sinus node recovery times (cSNRT) (−142 ± 204 msec, p = 0.114), a shortening of the AH interval (−31 ± 26 msec, p = 0.008), a reduction of the effective refractory period of the atrio-ventricular node (−156; interquartile range from −30 to −160 msec, p = 0.042) and an increase in the Wencheback point (27 ± 20 bpm, p < 0.001). At follow-up, a single patient, due to persistent symptoms and bradyarrhythmic disorder, underwent permanent pacemaker implantation; no other patient had recurrence of syncope, and all remained persistently asymptomatic.ConclusionOur results confirm the efficacy and safety of CNA for the treatment of VVS and functional bradyarrhythmias, although further studies are needed to support these findings.https://www.frontiersin.org/articles/10.3389/fcvm.2024.1526825/fullreflex syncopebradycardiaatrio-ventricular blockcardioneuroablationneuromodulationcatheter ablation |
| spellingShingle | Noemi Valenti Antonio Di Monaco Imma Romanazzi Nicola Vitulano Federica Troisi Federico Quadrini Antonio Vitullo Luca Sgarra Rosa Caruso Vincenzo Anzelmo Pietro Guida Natale Daniele Brunetti Massimo Grimaldi Cardioneuroablation for reflex syncope or functional bradyarrhytmias: new insight from a single center experience Frontiers in Cardiovascular Medicine reflex syncope bradycardia atrio-ventricular block cardioneuroablation neuromodulation catheter ablation |
| title | Cardioneuroablation for reflex syncope or functional bradyarrhytmias: new insight from a single center experience |
| title_full | Cardioneuroablation for reflex syncope or functional bradyarrhytmias: new insight from a single center experience |
| title_fullStr | Cardioneuroablation for reflex syncope or functional bradyarrhytmias: new insight from a single center experience |
| title_full_unstemmed | Cardioneuroablation for reflex syncope or functional bradyarrhytmias: new insight from a single center experience |
| title_short | Cardioneuroablation for reflex syncope or functional bradyarrhytmias: new insight from a single center experience |
| title_sort | cardioneuroablation for reflex syncope or functional bradyarrhytmias new insight from a single center experience |
| topic | reflex syncope bradycardia atrio-ventricular block cardioneuroablation neuromodulation catheter ablation |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1526825/full |
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