Cardioneuroablation

Cardioneuroablation
Specialty	Cardiology
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A frequent type of syncope, termed vasovagal syncope is originated by intense cardioinhibition, mediated by a sudden vagal reflex, that causes transitory cardiac arrest by asystole and/or transient total atrioventricular block.^[1]^[2] It is known as “Vaso-vagal Syncope”, “Neurocardiogenic Syncope” or “Neurally-mediated Reflex Syncope”.^[3] Although many different therapies have been tried in this condition, severe and refractory cases have been treated with pacemaker implantation despite great controversies about its benefit.^[4]^[5]

The “Cardioneuroablation” is a technique created in the nineties and patented in USA, aiming to eliminate the cardiac branch of vagal reflex in order to treat the neurocardiogenic syncope without pacemaker implantation.^[6]^[7] It is performed without surgery, by using radiofrequency catheter ablation with one-day hospital.^{[citation needed]}

The results up to 100 months follow-up are showing better outcome than clinical measures or pacemaker implantation with changing the tilt-test on to normal and by absence of syncope in more than 90% of patients without medications.^[8]^[9]

↑ Brignole M, Alboni P, Benditt DG, Bergfeldt L, Blanc JJ, Bloch Thomsen PE, van Dijk JG, Fitzpatrick A, Hohnloser S, Janousek J, Kapoor W, Kenny RA, Kulakowski P, Masotti G, Moya A, Raviele A, Sutton R, Theodorakis G, Ungar A, Wieling W (November 2004). "Guidelines on management (diagnosis and treatment) of syncope—update 2004". Europace. 6 (6): 467–537. doi:10.1016/j.eupc.2004.08.008. PMID 15519256.
↑ Morillo CA, Eckberg DL, Ellenbogen KA, Beightol LA, Hoag JB, Tahvanainen KU, Kuusela TA, Diedrich AM (October 1997). "Vagal and sympathetic mechanisms in patients with orthostatic vasovagal syncope". Circulation. 96 (8): 2509–13. doi:10.1161/01.cir.96.8.2509. PMID 9355886.
↑ Olshansky B - Pathogenesis and etiology of syncope - 2013 UpToDate – www.uptodate.com
↑ Raviele A, Giada F, Menozzi C, Speca G, Orazi S, Gasparini G, Sutton R, Brignole M (October 2004). "A randomized, double-blind, placebo-controlled study of permanent cardiac pacing for the treatment of recurrent tilt-induced vasovagal syncope. The vasovagal syncope and pacing trial (SYNPACE)". Eur Heart J. 25 (19): 1741–8. doi:10.1016/j.ehj.2004.06.031. PMID 15451153.
↑ Connolly SJ, Sheldon R, Thorpe KE, Roberts RS, Ellenbogen KA, Wilkoff BL, Morillo C, Gent M (May 2003). "Pacemaker therapy for prevention of syncope in patients with recurrent severe vasovagal syncope: Second Vasovagal Pacemaker Study (VPS II): a randomized trial". JAMA. 289 (17): 2224–9. doi:10.1001/jama.289.17.2224. PMID 12734133.
↑ Pachon JC, Pachon EI, Pachon JC, Lobo TJ, Pachon MZ, Vargas RN, Jatene AD (January 2005). ""Cardioneuroablation"—new treatment for neurocardiogenic syncope, functional AV block and sinus dysfunction using catheter RF-ablation". Europace. 7 (1): 1–13. doi:10.1016/j.eupc.2004.10.003. PMID 15670960.
↑ Pachon M JC, Pachon M EI, Lobo TJ, Pachon M JC, Pachon MZ, Vargas RN, Manrique RM, Jatene AD (March 2006). "Syncopal high-degree AV block treated with catheter RF ablation without pacemaker implantation". Pacing Clin Electrophysiol. 29 (3): 318–22. doi:10.1111/j.1540-8159.2006.00340.x. PMID 16606401.
↑ Pachon JC, Pachon EI, Cunha Pachon MZ, Lobo TJ, Pachon JC, Santillana TG (September 2011). "Catheter ablation of severe neurally meditated reflex (neurocardiogenic or vasovagal) syncope: cardioneuroablation long-term results". Europace. 13 (9): 1231–42. doi:10.1093/europace/eur163. PMID 21712276.
↑ Barón-Esquivias G, Errázquin F, Pedrote A, Cayuela A, Gómez S, Aguilera A, Campos A, Fernández M, Valle JI, Redondo M, Fernández JM, Martínez A, Burgos J, Martínez-Rubio A (May 2004). "Long-term outcome of patients with vasovagal syncope". Am Heart J. 147 (5): 883–9. doi:10.1016/j.ahj.2003.11.022. PMID 15131546.

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