Frontiers in Cardiovascular Medicine,
Год журнала:
2024,
Номер
11
Опубликована: Июль 26, 2024
Cardioneuroablation
(CNA)
is
a
novel
interventional
procedure
for
the
treatment
of
recurrent
vasovagal
syncope
(VVS)
and
advanced
atrioventricular
block
secondary
to
hyperactivation
vagal
tone
in
young
patients.
By
damaging
cardiac
parasympathetic
ganglia,
CNA
seems
be
able
mitigate
and/or
abolish
excessive
activity
improve
patients'
outcome.
This
review
intended
give
detailed
comprehensive
overview
current
evidences
regarding
(1)
clinical
applications
(2)
identification
ablation
targets
procedural
endpoints
(3)
medium-long
term
effect
its
future
perspectives.
However,
data
are
still
limited,
expert
consensus
or
recommendations
guidelines
this
technique
lacking.
Journal of Clinical Medicine,
Год журнала:
2024,
Номер
13(3), С. 727 - 727
Опубликована: Янв. 26, 2024
Syncope
is
a
highly
prevalent
clinical
condition
characterized
by
rapid,
complete,
and
brief
loss
of
consciousness,
followed
full
recovery
caused
cerebral
hypoperfusion.
This
symptom
carries
significance,
as
its
potential
underlying
causes
may
involve
the
heart,
blood
pressure,
or
brain,
leading
to
spectrum
consequences,
from
sudden
death
compromised
quality
life.
Various
factors
contribute
syncope,
adhering
precise
diagnostic
pathway
can
enhance
accuracy
treatment
effectiveness.
A
standardized
initial
assessment,
risk
stratification,
appropriate
test
identification
facilitate
determining
cause
in
majority
cases.
New
technologies,
including
artificial
intelligence
smart
devices,
have
reshape
syncope
management
into
proactive,
personalized,
data-centric
model,
ultimately
enhancing
patient
outcomes
review
addresses
key
aspects
management,
pathogenesis,
current
testing
options,
treatments,
considerations
geriatric
population.
European Heart Journal Supplements,
Год журнала:
2025,
Номер
27(Supplement_1), С. i171 - i176
Опубликована: Фев. 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.
Frontiers in Cardiovascular Medicine,
Год журнала:
2025,
Номер
11
Опубликована: Янв. 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.
Journal of Cardiovascular Medicine,
Год журнала:
2025,
Номер
26(3), С. 131 - 142
Опубликована: Янв. 27, 2025
Cardioneuroablation
(CNA)
is
emerging
as
an
appealing
therapeutic
option
for
patients
with
vasovagal
reflex
syncope.
This
review
examines
key
aspects
of
CNA,
including
patient
selection,
procedural
and
mid-term
effects.
We
critically
evaluate
results
from
recent
studies
address
ongoing
challenges,
such
the
need
standardized
protocols
harmonized
postprocedural
data
collection.
In
addition,
we
outline
current
gaps
in
knowledge
concerning
long-term
pathophysiological
effects
procedure,
particular
regarding
ventricular
arrhythmia
susceptibility
exercise
capacity.
Journal of Cardiovascular Electrophysiology,
Год журнала:
2025,
Номер
unknown
Опубликована: Фев. 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.
