Interventions aimed to increase average 24-h systolic blood pressure reduce blood pressure drops in patients with reflex syncope and orthostatic intolerance

Groppelli, Antonella; Rivasi, Giulia; Fedorowski, Artur; de Lange, Frederik J; Russo, Vincenzo; Maggi, Roberto; Capacci, Marco; Nawaz, Sara; Comune, Angelo; Bianchi, Lorenzo; Zambon, Antonella; Soranna, Davide; Ungar, Andrea; Parati, Gianfranco; Brignole, Michele

doi:10.1093/europace/euae026

Cited by 4 publications

(1 citation statement)

References 38 publications

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“… 24–26 An increase in average 24 h systolic blood pressure, regardless of the implemented strategy, significantly reduced symptom burden. 27 …”

Section: Discussionmentioning

confidence: 99%

Procedural and Intermediate-term Results of the Electroanatomical-guided Cardioneuroablation for the Treatment of Supra-Hisian Second- or Advanced-degree Atrioventricular Block: the PIRECNA multicentre registry

Aksu,

Piotrowski,

Tung

et al. 2024

Europace

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Aims Prior case series showed promising results for cardioneuroablation in patients with vagally induced atrioventricular blocks (VAVBs). We aimed to examine the acute procedural characteristics and intermediate-term outcomes of electroanatomical-guided cardioneuroablation (EACNA) in patients with VAVB. Methods and results This international multicentre retrospective registry included data collected from 20 centres. Patients presenting with symptomatic paroxysmal or persistent VAVB were included in the study. All patients underwent EACNA. Procedural success was defined by the acute reversal of atrioventricular blocks (AVBs) and complete abolition of atropine response. The primary outcome was occurrence of syncope and daytime second- or advanced-degree AVB on serial prolonged electrocardiogram monitoring during follow-up. A total of 130 patients underwent EACNA. Acute procedural success was achieved in 96.2% of the cases. During a median follow-up of 300 days (150, 496), the primary outcome occurred in 17/125 (14%) cases with acute procedural success (recurrence of AVB in 9 and new syncope in 8 cases). Operator experience and use of extracardiac vagal stimulation were similar for patients with and without primary outcomes. A history of atrial fibrillation, hypertension, and coronary artery disease was associated with a higher primary outcome occurrence. Only four patients with primary outcome required pacemaker placement during follow-up. Conclusion This is the largest multicentre study demonstrating the feasibility of EACNA with encouraging intermediate-term outcomes in selected patients with VAVB. Studies investigating the effect on burden of daytime symptoms caused by the AVB are required to confirm these findings.

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“… 24–26 An increase in average 24 h systolic blood pressure, regardless of the implemented strategy, significantly reduced symptom burden. 27 …”

Section: Discussionmentioning

confidence: 99%