Pan African Medical Journal,
Journal Year:
2024,
Volume and Issue:
48
Published: Jan. 1, 2024
This
study
assessed
the
safety
of
Antiarrhythmic
Drug
(AAD)
administration
in
a
patient
experiencing
sinus
bradycardia
following
radiofrequency
ablation
for
Atrial
Fibrillation
(AF),
followed
by
cardiac
ganglion
ablation.
Post-AF
ablation,
employment
AADs
is
prevalent
clinical
practice;
however,
these
drugs
may
exacerbate
bradycardia,
leading
to
increased
discomfort
and
treatment
complexity.
The
decision
employ
patients
with
post-AF
poses
significant
challenge.
investigation
aimed
ascertain
such
patients.
encompassed
single
case,
wherein
pre-
post-procedure
was
treated
AF
subsequent
assessment.
findings
indicate
that
can
be
safely
administered
after
procedures,
offering
valuable
insights
decision-making.
case
report
underscores
intricacies
management
advocates
personalized
therapeutic
strategies.
results
enhance
knowledge
regarding
this
subset
guide
future
protocols.
Nonetheless,
study's
conclusions
are
drawn
from
further
research
larger
cohorts
essential
substantiate
elucidate
long-term
efficacy
approach.
Biology,
Journal Year:
2024,
Volume and Issue:
13(2), P. 105 - 105
Published: Feb. 7, 2024
The
cardiac
autonomic
nervous
system
(CANS)
plays
a
pivotal
role
in
homeostasis
as
well
pathology.
first
level
of
control,
the
intrinsic
(ICNS),
is
located
within
epicardial
fat
pads
and
physically
organized
ganglionated
plexi
(GPs).
ICNS
does
not
only
contain
parasympathetic
efferent
neurons,
long
believed,
but
also
afferent
neurons
local
circuit
neurons.
Thanks
to
its
high
degree
connectivity,
combined
with
neuronal
plasticity
memory
capacity,
allows
for
beat-to-beat
control
all
functions
responses
integration
extracardiac
higher
centers
longer-term
cardiovascular
reflexes.
present
review
provides
detailed
overview
current
knowledge
bidirectional
connection
between
most
studied
pathologies/conditions
(myocardial
infarction,
heart
failure,
arrhythmias
transplant)
potential
therapeutic
implications.
Indeed,
GP
modulation
activity
inhibition,
differently
achieved,
has
been
atrial
fibrillation
functional
bradyarrhythmias,
while
stimulation
evaluated
myocardial
failure
ventricular
arrhythmias.
Electrical
therapy
unique
allow
both
kinds
preserving
anatomical
integrity
system.
Frontiers in Cardiovascular Medicine,
Journal Year:
2025,
Volume and Issue:
11
Published: Jan. 13, 2025
Background
Cardioneuroablation
(CNA)
is
a
new
approach
to
treat
reflex
syncope
and
functional
bradyarrhytmias
caused
by
autonomic
imbalance.
We
report
our
experience
using
CNA.
Method
From
September
2022
July
2023,
we
took
care
of
21
patients
(mean
age
42
±
years;
62%
male)
affected
or
bradyarrhythmias.
All
underwent
CNA
under
conscious
sedation
targeting
the
superior
and/or
inferior
paraseptal
ganglionated
plexus
(GPs).
Results
Nine
were
vasovagal
(VVS)
twelve
In
3
cases
(14%)
ablation
was
performed
only
on
GPs
right
atrium,
while
in
remaining
86%
biatrial
lesions.
As
regards
acute
results,
highlighted
an
increase
sinus
heart
rate
(12
15
bpm,
p
=
0.001),
shortening
PQ
interval
(−18
18
msec,
<
reduction
correct
node
recovery
times
(cSNRT)
(−142
204
0.114),
AH
(−31
26
0.008),
effective
refractory
period
atrio-ventricular
(−156;
interquartile
range
from
−30
−160
0.042)
Wencheback
point
(27
20
0.001).
At
follow-up,
single
patient,
due
persistent
symptoms
bradyarrhythmic
disorder,
permanent
pacemaker
implantation;
no
other
patient
had
recurrence
syncope,
all
remained
persistently
asymptomatic.
Conclusion
Our
results
confirm
efficacy
safety
for
treatment
VVS
bradyarrhythmias,
although
further
studies
are
needed
support
these
findings.
Vasovagal
syncope
(VVS)
is
the
most
common
cause
of
syncope,
and
significantly
impacts
quality
life
despite
its
benign
nature.
For
some
patients,
conventional
management
strategies
such
as
lifestyle
changes,
pharmacotherapy
pacemaker
implantation,
fail
to
prevent
recurrence.
Cardioneuroablation
(CNA),
a
novel
intervention
targeting
cardiac
autonomic
nervous
system’s
ganglionated
plexi,
has
shown
promise
in
addressing
refractory
VVS.
This
review
examines
therapeutic
potential
CNA,
exploring
anatomy
physiology
system,
role
plexi
regulation
rationale
behind
their
selection
ablation
targets.
The
also
discusses
diverse
for
identification
ablation.
gateway
hypothesis
used
explain
success
CNA
across
varied
procedural
methods,
absence
standardized
technique.
These
located
near
sinoatrial
atrioventricular
nodes,
potentially
serve
central
nodes
influencing
heart
rhythm
rate,
thus
explaining
high
rates
VVS
treatment
using
different
approaches.
Journal of Clinical Medicine,
Journal Year:
2025,
Volume and Issue:
14(2), P. 592 - 592
Published: Jan. 17, 2025
Cardioneuroablation
is
a
rapidly
developing
procedure
for
the
treatment
of
vagally
mediated
bradyarrhythmias.
However,
lack
multicenter,
randomized
trials
prevents
it
from
being
included
in
bradyarrhythmia
guidelines.
So
far,
only
one
small,
study
has
been
published
assessing
effectiveness
this
method
reflex
syncope.
This
brief
review
ongoing
evaluating
and
safety
cardioneuroablation
functional
European Heart Journal Supplements,
Journal Year:
2025,
Volume and Issue:
27(Supplement_1), P. i171 - i176
Published: Feb. 1, 2025
Cardioneuroablation
(CNA)
is
now
recognized
as
a
safe
and
effective
method
in
patients
with
cardioinhibitory
neurocardiogenic
syncope
(CNCS),
especially
young
order
to
avoid
or
prolong,
much
possible,
the
timing
of
definitive
cardiac
pacing.
Several
investigations
have
shown
beneficial
very
satisfactory
results
standard
non-extensive
endocardial
ablation,
aimed
at
identifying
high-amplitude
fragmented
signals
right
left
atria.
Despite
this,
current
scientific
debate
focused
about
proposal
on
an
ablative
method,
even
more
individualized
than
CNA
(at
least
first
approach),
considering
that
standardized
approach,
atrium,
could
expose
CNCS
good
prognosis
excessive
risk
complications.
These
findings,
moving
from
concept
new
'cardioneuromodulation',
opened
era,
treatment
different
clinical
scenarios
vagally-mediated
atrioventricular
block
sinus-atrial
node
dysfunction.
Journal of Cardiovascular Electrophysiology,
Journal Year:
2025,
Volume and Issue:
unknown
Published: Feb. 19, 2025
ABSTRACT
Neurocardiology
has
mostly
been
a
specialty
of
medicine
led
by
anatomists
and
physiologists.
The
characterization
the
cardiac
autonomic
nervous
system
resulted
in
new
understanding
appreciation
neurocardiology,
leading
to
potential
novel
neuromodulation
therapies
clinical
cardiology
electrophysiology.
Sympathectomy
or
spinal
cord
stimulation
for
treatment
angina
pectoris,
as
well
sympathetic
denervation
long
QT
syndrome
associated
with
malignant
ventricular
arrhythmias,
have
available
performed
more
than
half
century.
However,
emerged,
based
on
contemporary
research
findings,
assisted
state‐of‐the
art
imaging
ablation
techniques.
Patients
structural
heart
disease
symptomatic
ectopy,
can
potentially
benefit
from
techniques
reduce
tone,
such
stellate
ganglionic
block,
epidural
anesthesia
denervation.
Renal
not
only
shown
ameliorate
patients
hypertension,
but
may
also
atrial
arrhythmias.
failure
be
improved
clinically
potentiating
parasympathetic
tone.
Cardiac
mapping
ganglia
nerves
delineate
regions
that
suppress
fibrillation,
treat
bradyarrhythmias
cardio‐inhibitory
syncope.
Scientific Reports,
Journal Year:
2025,
Volume and Issue:
15(1)
Published: Feb. 24, 2025
The
autonomic
regulation
of
heart
rate
(HR)
reactivity
to
acute
hypoxia
remains
unclear.
Parasympathetic
cardioneuroablation
(PCNA)
may
serve
as
a
novel
model
for
the
analysis
physiological
consequences
reduced
vagal
influence
over
sinus
node
in
humans.
We
studied
11
adult
patients
scheduled
PCNA
treatment
vasovagal
syncope.
HR
was
before
and
after
with
brief
nitrogen
gas
administrations.
Each
test
followed
by
an
atropine
challenge
evaluate
contribution
parasympathetic
tone
resting
HR.
Additionally,
we
assessed
changes
cardiac
baroreflex
sensitivity
variability
following
procedure.
led
partial
denervation
at
rest
(67.0
±
20.1%).
This
translated
into
significant
change
(0.58
0.21
vs.
0.22
0.13
beats
min−
1%SpO2
−
1,
p
=
0.0001)
which
proportional
degree
(R
0.76,
0.01).
There
no
peak
on
implying
unchanged
sympathetic
input
node.
suggests
that
is
significantly
influenced
system.
despite
incomplete
resulted
profoundly
depressed
sensitivity.
clinical
meaning
latter
should
be
explored
further
studies.
Ukrainian Journal of Cardiology,
Journal Year:
2025,
Volume and Issue:
32(2), P. 67 - 74
Published: April 28, 2025
The
aim
–
considering
worldwide
experience,
it
is
necessary
to
analyze
scientific
articles
about
ablation
of
ganglion
plexi
(GP)
(cardioneuroabaltion)
for
patients
with
vasovagal
syncope
(VVS).Searching
was
performed
well-known
online-library
PubMed.
203
were
found
in
different
journals.
selection
an
essential
factor
during
preprocedural
period
order
predict
results
cardioneuroablation.
Ablation
both
right
and
left
atrium
has
showed
the
best
effectiveness.
Moreover,
extracardiac
vagal
stimulation
may
be
advanced
method
check
acute
after
parasympathetic
denervation.The
first
article
treatment
VVS
been
published
by
Pachon
et
al.
2005,
that
presented
reduced
rate
recurrent
cardioneuroabaltion.
Results
randomized
clinical
trial
have
R.
Piotrowski
al.,
which
48
enrolled
divided
into
two
groups
24
respectively.
Group,
where
cardioneuroablation
performed,
decreased
level
recurrence
contrast
group,
conservative
therapy
introduced
(8
%
54
respectively).
comparing
impact
between
pacemaker
implantation
being
started
2024
(TELE-SPACER).Conclusions.
choosing
appropriate
still
discussed.
Cardineuroablation
become
effective
safe
option
especially
young
people.
