Long-term Efficacy and Safety of Cardioneuroablation in Patients with Vagally Mediated Bradyarrhythmias
Journal Title: E Journal of Cardiovascular Medicine - Year 2020, Vol 8, Issue 1
Abstract
Objectives: Long-term efficacy and safety are still uncertain in patients with vagally mediated bradyarrhythmias (VMB) undergoing cardioneuroablation (CNA). Thus, we assessed the outcome of CNA in those patients during long-term follow-up using clinical history in outpatient visits. Materials and Methods: A total of 27 patients (42.7±14 years; 17 (63.0% men) were included in this study. The main mechanism involved in the occurrence of syncope was vasovagal syncope in 16 (59.3%) patients, functional atrioventricular block (AVB) in seven (25.9%) patients, and sinus bradycardia or pauses in four (14.8%) patients. The ablation strategy included right-sided or bi-atrial ablation of ganglionated plexi. Syncope recurrences were assessed clinically during follow-up. Results: Acute procedural endpoints were achieved in 26 (96.2%) of cases. During a median follow-up period of 52 months (IQR, 28-56 months), all but 2 (7.4%) of 27 patients were free of new syncope. Significant clinical and ECG improvement was detected in four (57.1%) of seven patients with AVB. In the remaining two patients except one patient with acute failure, pacemaker was implanted despite no syncope recurrence because evening time variable-degree AVB episodes were seen on follow-up Holter recordings. Procedure related complication was not seen in any cases. Symptoms attributed inappropriate sinus tachycardia was observed in two patients. Conclusion: Our results demonstrate long-term efficacy and safety of cardiovascular autonomic neuropathy in patients with VMB. Randomized controlled studies are needed to define long-term efficacy and safety of cardioneuroablation.
Authors and Affiliations
Tümer Erdem Güler, Tolga Aksu
Keywords
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- EP ID EP685156
- DOI 10.32596/ejcm.galenos.2020.02.07
- Views 164
- Downloads 0
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