Sinus Node Artery Occlusion During Cardiac Denervation Procedures

Scanavacca, Maurício; Rivarola, Esteban Wisnivesky Rocca; Torres, Roberto Vitor Almeida; Hardy, Carina; Wu, Tan Chen; Darrieux, Francisco; Pisani, Cristiano; Hachul, Denise

doi:10.1016/j.jaccas.2022.04.021

Cited by 11 publications

(8 citation statements)

References 10 publications

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“…Injuries of the sinoatrial node and of the AV node (and their arteries) have been seldom reported. 45 Phrenic nerve palsy after the RA ablation and coronary artery damage (specifically, occlusion of the distal circumflex artery after the proximal coronary sinus ablation) were observed but are rare (D. Wichterle, personal communication). This issue is particularly important in the setting of a benign disease such as reflex syncope and other vagally-dependent syndromes.…”

Section: Additional Controversial Issues (Gap In Knowledge)mentioning

confidence: 99%

Clinical controversy: methodology and indications of cardioneuroablation for reflex syncope

et al. 2023

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Graphical Abstract Graphical Abstract Observational studies and a recent randomized controlled trial have provided some evidence that cardioneuroablation (CNA) may prevent syncope recurrence in patients affected by cardioinhibitory reflex syncope during the first 2 years following the procedure. Nevertheless, many issues concerning clinical indications, methodology, and long-term results remain unresolved. These issues constitute the background of this manuscript in which pioneers in CNA and experts in syncope debated critical aspects aimed at finding agreement or, if not possible, that highlighting the controversies could be addressed in future studies.

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Section: Additional Controversial Issues (Gap In Knowledge)mentioning

confidence: 99%

Clinical controversy: methodology and indications of cardioneuroablation for reflex syncope

et al. 2023

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“…Scanavacca et al reported acute occlusion of the sinus node artery after CNA procedures in two patients. 61 The authors suggested operators take measures to prevent it, including evaluating the aortic angulation in older patients before the procedure. No more severe complications of CNA have been reported.…”

Section: Safety Of Cardioneuroablationmentioning

confidence: 99%

Cardioneuroablation for Treating Vasovagal Syncope: Current Status and Future Directions

Yao

2023

Arrhythm Electrophysiol Rev

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Syncope is defined by transient and spontaneous loss of consciousness with rapid recovery. Vasovagal syncope (VVS) is the most common form of syncope and is strongly associated with hypervagotonia. There is, however, a lack of effective therapies for VVS. Cardioneuroablation (CNA) is an emerging and promising intervention for VVS with favourable outcomes. CNA has been shown to suppress excessive excitation of vagal activity through ablating the cardiac ganglionated plexi. CNA in the management of VVS requires more structured and comprehensive studies and several issues concerning patient selection, selection of ablation targets, ablation endpoints and the long-term effect of CNA are yet to be determined. This review describes its clinical applications and future directions based on current research data and the authors’ own experiences.

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“…We would like to thank Dr Debruyne for his interest in our paper. 1 Based on his observations with >130 procedures and no acute sinus node dysfunction, Dr Debruyne proposes to limit ablation to the posterior aspect of the superior vena cava (SVC) and to limit the contact force to avoid sinus node artery (SNA) lesions.…”

mentioning

confidence: 99%

“…It is worth mentioning that SNA flow can be spontaneously restored after occlusion (as in patient 2), resulting in a transient sinus dysfunction that could go unnoticed and unreported. 1 …”

mentioning

confidence: 99%

“…We congratulate Dr Debruyne for his remarkable record of 130 cases (by referring only refractory patients, our group has performed 42 cases since 2007; 1 and Dr Pachon’s group, who first described the method in 2005, reports 83 procedures 3 ). However, larger experience (frequently of many hundreds of cases), is necessary for a full assessment of the effects and risks of any given treatment.…”

Sinus Node Artery Occlusion During Cardiac Denervation Procedures

Cited by 11 publications

References 10 publications

Clinical controversy: methodology and indications of cardioneuroablation for reflex syncope

Clinical controversy: methodology and indications of cardioneuroablation for reflex syncope

Cardioneuroablation for Treating Vasovagal Syncope: Current Status and Future Directions

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