Fractionation Mapping of the Ganglionated Plexi for Cardioneuroablation
| Autor: | Tolga Aksu, Leah John, Roderick Tung, Jeffrey Winterfield, Joshua E. Payne, Andin Mullis |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Tachycardia
medicine.medical_specialty Cardiac mapping business.industry medicine.medical_treatment Syncopal episodes Case Report Cardioinhibitory ganglionated plexi medicine.disease Ablation cardioneuroablation high-density mapping vasovagal syncope Standardized technique Cardioneuroablation Physiology (medical) Internal medicine Implantable loop recorder Cardiology Medicine medicine.symptom Cardiology and Cardiovascular Medicine business Vasovagal syncope |
| Zdroj: | The Journal of Innovations in Cardiac Rhythm Management |
| ISSN: | 2156-3993 2156-3977 |
| DOI: | 10.19102/icrm.2021.120405 |
| Popis: | Cardioneuroablation (CNA) is an emerging technique used to treat patients with vasovagal syncope (VVS). We herein describe a case of CNA targeting the atrial ganglionated plexi (GPs) based upon anatomical landmarks and fractionated electrogram (EGM) localization in a 20-year-old healthy female who presented to our center with malignant VVS and symptomatic sinus pauses, the longest of which measured 10 seconds. She underwent acutely successful CNA with a demonstration of vagal response noted following ablation of the left-sided GPs, and tachycardia was noted with right-sided GP ablation. All GP sites were defined by anatomical landmarks and EGM analysis. By using the fractionation mapping software of the EnSite Precision™ cardiac mapping system (Abbott, Chicago, IL, USA) with high-density mapping, fragmented EGMs were successfully detected in each GP site. One month after vagal denervation, no recurrent syncopal episodes or sinus pauses had been recorded. Longer-term follow-up with an implantable loop recorder is planned. Broadly, we performed CNA in a patient with VVS by combining high-density mapping and fractionation mapping software in a novel approach, which allowed us to detect fractionation in all GP sites and demonstrate an acute vagal response. This workflow may facilitate the introduction of a standardized technique suitable for widespread use. |
| Databáze: | OpenAIRE |
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