A novel strategy to treat vaso-vagal syncope: Cardiac neuromodulation by cryoballoon pulmonary vein isolation

Autor: Riccardo Maj, Thiago Guimarães Osório, Gianluca Borio, Saverio Iacopino, Erwin Ströker, Juan Sieira, Muryo Terasawa, Shuichiro Kazawa, Alessandro Rizzo, Alessio Galli, Varnavas Varnavas, Gezim Bala, Xavier Galloo, Gaetano Paparella, Pedro Brugada, Yves De Greef, Carlo De Asmundis, Gian Battista Chierchia
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Indian Pacing and Electrophysiology Journal, Vol 20, Iss 4, Pp 154-159 (2020)
Druh dokumentu: article
ISSN: 0972-6292
DOI: 10.1016/j.ipej.2020.03.008
Popis: Background: Clinical management of vaso-vagal syncope (VVS) remains challenging since no therapy has proven to completely prevent VVS recurrence. Objective: The purpose of this study was to analyze the mid-term outcome of cryoballoon (CB) cardioneuroablation achieved by pulmonary vein isolation (PVI) in patients with VVS. Methods: Patients who underwent CB cardioneuroablation in our centers between January 2014 to June 2018 were included. All patients had a history of VVS or pre-syncope despite therapeutic attempts with medical and/or pacing treatments. Patients were excluded in case of structural heart diseases, cerebrovascular diseases or suspected drug-related syncope. Both heart rate (HR) and atrio-ventricular (AV) interval were analyzed on the 12-lead electrocardiogram (ECG) the day before the procedure, the day after, and in the follow-up. Results: In total, 26 patients (76.9% males, 37.5 ± 9.0 years old) were included. All patients underwent a successful procedure with the 28 mm second-generation Arctic Front Advance CB. No major complication occurred. At a mean follow-up of 20.1 ± 11.6 months the freedom from VVS or reflex pre-syncope was 83,7%, with 22 patients free from any clinical recurrence. Basal HR significantly increased the day after the procedure (57.2 bpm vs 78.3 bpm, p
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