Syncopal High‐Degree AV Block Treated with Catheter RF Ablation without Pacemaker Implantation

M, Jose C. Pachon; M, Enrique I. Pachon; Lobo, Tasso J.; M, Juan C. Pachon; Pachón, Maria Zélia Cunha; Vargas, Remy Nélson Albornoz; Manrique, Ricardo M; Jatene, Adib

doi:10.1111/j.1540-8159.2006.00340.x

Cited by 48 publications

(43 citation statements)

References 11 publications

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“…In 2006, Pachon et al reported that spectral mapping–guided vagal denervation achieved symptomatic relief in 6 patients with neural mediate syncope during an average follow‐up of 9 months. They updated their research in 43 patients with important cardioinhibition during a HUT in 2011 .…”

Section: Discussionmentioning

confidence: 99%

Catheter Ablation as a Treatment for Vasovagal Syncope: Long‐Term Outcome of Endocardial Autonomic Modification of the Left Atrium

Sun

Zheng

et al. 2016

JAHA

119

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BackgroundAutonomic modification through catheter ablation of ganglionated plexi (GPs) in the left atrium has been reported previously as a treatment for vasovagal syncope. This study aimed to observe the long‐term outcome in a larger cohort.Methods and ResultsA total of 57 consecutive patients (aged 43.2±13.4 years; 35 women) with refractory vasovagal syncope were enrolled, and high‐frequency stimulation and anatomically guided GP ablation were performed in 10 and 47 cases, respectively. A total of 127 GP sites with positive vagal response were successfully elicited and ablated, including 52 left superior, 19 left lateral, 18 left inferior, 27 right anterior, and 11 right inferior GPs. During follow‐up of 36.4±22.2 months (range 12–102 months), 52 patients (91.2%) remained free from syncope. Prodromes recurred in 16 patients. No statistical differences were found between the high‐frequency stimulation and anatomically guided ablation groups in either freedom from syncope (100% versus 89.4%, P=0.348) or recurrent prodromes (50% versus 76.6%, P=0.167). The deceleration capacity, heart rate, and heart rate variability measurements demonstrated a reduced vagal tone lasting for at least 12 months after the procedure, with improved tolerance of repeated head‐up tilt testing. No complications were observed except for transient sinus tachycardia that occurred in 1 patient.ConclusionsLeft atrial GP ablation showed excellent long‐term clinical outcomes and might be considered as a therapeutic option for patients with symptomatic vasovagal syncope.

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Section: Discussionmentioning

confidence: 99%

Catheter Ablation as a Treatment for Vasovagal Syncope: Long‐Term Outcome of Endocardial Autonomic Modification of the Left Atrium

Sun

Zheng

et al. 2016

JAHA

119

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“…The long-term results of increased heart rate must be reconstructed in long-term follow-up studies. Pachon et al 10 reported the long-term results of a patient with high-degree AV block who underwent the cardioneuroablation procedure guided by spectral endocardial mapping. The electrophysiologic parameters normalized and the patient was asymptomatic, leading a normal life at follow-up 21 months later.…”

Section: Discussionmentioning

confidence: 99%

Functional permanent 2:1 atrioventricular block treated with cardioneuroablation: Case report

Aksu¹,

Gölcük²,

Güler³

et al. 2015

HeartRhythm Case Reports

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“…Pachon et al 16 reported that the cardiac autonomic modulation through catheter ablation guided by Fast-Fourier Transform analysis was an alternative treatment for refractory neurally mediated syncope. In this study, 6 patients who underwent this procedure had symptomatic relief at a follow-up period up to 9 months.…”

Section: Previous Studiesmentioning

confidence: 99%

Endocardial Autonomic Denervation of the Left Atrium to Treat Vasovagal Syncope

Yao

Shi

Wong

et al. 2012

Circ: Arrhythmia and Electrophysiology

131

133

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Background-Vasovagal syncope (VVS) is the most common cause of recurrent syncope that can be debilitating despite optimal conventional therapy. The aim of this study was to evaluate the feasibility and efficacy of selective endocardial autonomic denervation in left atrium (LA) as an alternative treatment strategy in patients with highly symptomatic VVS. Methods and Results-Ten consecutive patients (mean age, 50.4Ϯ6.4 years; 7 women) with a medium of 3.5 (range, 2-20) recurrent episodes of VVS during the preceding year and positive head-up tilt testing in whom standard therapies were ineffective or poorly tolerated were enrolled. Ganglionated plexi (GP) in the LA, identified by high-frequency stimulation, was targeted by radiofrequency catheter ablation. The patients were then followed up at 3, 6, 12, 24, and 36 months, including repeated head-up tilt testing and Holter at 3 and 12 months. Radiofrequency energy was applied at the left superior GP in 10 patients, right anterior GP in 5, and left inferior GP in 3, using an 8-mm ablation catheter.

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Syncopal High‐Degree AV Block Treated with Catheter RF Ablation without Pacemaker Implantation

Cited by 48 publications

References 11 publications

Catheter Ablation as a Treatment for Vasovagal Syncope: Long‐Term Outcome of Endocardial Autonomic Modification of the Left Atrium

Catheter Ablation as a Treatment for Vasovagal Syncope: Long‐Term Outcome of Endocardial Autonomic Modification of the Left Atrium

Functional permanent 2:1 atrioventricular block treated with cardioneuroablation: Case report

Endocardial Autonomic Denervation of the Left Atrium to Treat Vasovagal Syncope

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