Jamario Skeete, Jonathan S Gordon, Lincoln Kavinksy, Henry D Huang, Tolga Aksu
{"title":"Cardioneuroablation for the management of neurally mediated syncope, sinus bradycardia, and atrioventricular block.","authors":"Jamario Skeete, Jonathan S Gordon, Lincoln Kavinksy, Henry D Huang, Tolga Aksu","doi":"10.1007/s10840-024-01923-7","DOIUrl":null,"url":null,"abstract":"<p><p>Through several decades of medical advances, we have improved our understanding of the role of the autonomic nervous system in the production of a myriad of clinical cardiac conditions such as vasovagal syncope, situational syncope, carotid sinus hypersensitivity, vagally mediated sinus bradycardia, and atrioventricular block. While typically not associated with mortality, these common clinical entities may result in significant patient symptoms and morbidity and are often characterized by a frustrating treatment course with a paucity of effective strategies. In recent years, there has been increased interest in the management of these conditions via direct modulation of the parasympathetic component of the autonomic nervous system. This is achieved by targeting the ganglionated plexus central to the pathogenesis of these conditions via cardioneuroablation. The primary role of this strategy is evolving and serves to augment traditional treatment strategies such as lifestyle modification and pharmacotherapy. In this review, we examine the principles governing the role of cardioneuroablation in select populations with vasovagal syncope, sinus dysfunction, and atrioventricular block including the evolving evidence in this exciting field while keeping in mind the need for robust clinical studies examining the long-term effectiveness and safety.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Interventional Cardiac Electrophysiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10840-024-01923-7","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Through several decades of medical advances, we have improved our understanding of the role of the autonomic nervous system in the production of a myriad of clinical cardiac conditions such as vasovagal syncope, situational syncope, carotid sinus hypersensitivity, vagally mediated sinus bradycardia, and atrioventricular block. While typically not associated with mortality, these common clinical entities may result in significant patient symptoms and morbidity and are often characterized by a frustrating treatment course with a paucity of effective strategies. In recent years, there has been increased interest in the management of these conditions via direct modulation of the parasympathetic component of the autonomic nervous system. This is achieved by targeting the ganglionated plexus central to the pathogenesis of these conditions via cardioneuroablation. The primary role of this strategy is evolving and serves to augment traditional treatment strategies such as lifestyle modification and pharmacotherapy. In this review, we examine the principles governing the role of cardioneuroablation in select populations with vasovagal syncope, sinus dysfunction, and atrioventricular block including the evolving evidence in this exciting field while keeping in mind the need for robust clinical studies examining the long-term effectiveness and safety.
期刊介绍:
The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.