Fluoroscopy-free cardioneuroablation for functional bradycardia: a single-center experience.

IF 2.1 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Interventional Cardiac Electrophysiology Pub Date : 2024-10-10 DOI:10.1007/s10840-024-01926-4

Parnia Abolhassan Choubdar, Megan Gruber, Jose Carlos Pachon-M, Stephen Manu, Mansour Razminia, John Clark

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Abstract

Background: Cardioneuroablation (CNA) is an emerging treatment for cardioinhibitory syncope and functional AV block. This study aimed to evaluate the safety and efficacy of a fluoroless CNA approach using three-dimensional mapping and extracardiac vagal stimulation (ECVS).

Methods: This prospective observational study included 22 patients (mean age 21 years) with clinically significant functional bradycardia who underwent fluoroless CNA. Procedural success was defined as elimination or significant attenuation of the vagal response to ECVS.

Results: CNA was successfully performed in all patients with a mean procedure time of 251 min. Fluoroscopy was avoided in 91% of cases. At a mean follow-up of 11.4 months, 77% of patients remained symptom-free. Among pacemaker patients, 90% did not require further pacing, and 6/10 (60%) have had their pacemakers turned off. No complications were seen during the procedure.

Conclusions: Fluoroscopy-free CNA is a safe and effective treatment for functional bradycardia, offering high procedural success rates and favorable symptom-free outcomes while minimizing radiation exposure.

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治疗功能性心动过缓的无透视心脏神经消融术：单中心经验。

背景：心脏神经消融术（CNA）是治疗心抑制性晕厥和功能性房室传导阻滞的一种新兴疗法。本研究旨在评估使用三维映射和心外迷走神经刺激（ECVS）的无氟 CNA 方法的安全性和有效性：这项前瞻性观察研究纳入了 22 名接受无氟 CNA 治疗的临床显著功能性心动过缓患者（平均年龄 21 岁）。程序成功的定义是对 ECVS 的迷走神经反应消失或显著减弱：所有患者均成功实施了 CNA，平均手术时间为 251 分钟。91%的病例避免了透视检查。在平均 11.4 个月的随访中，77% 的患者仍无症状。在心脏起搏器患者中，90%的患者不需要继续起搏，6/10（60%）的患者已经关闭了心脏起搏器。手术期间未出现并发症：无透视 CNA 是治疗功能性心动过缓的一种安全有效的方法，手术成功率高，无症状效果好，同时最大限度地减少了辐射暴露。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Interventional Cardiac Electrophysiology 医学-心血管系统

CiteScore

4.30

自引率

11.10%

发文量

320

审稿时长

4-8 weeks

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.