Cardioneuroablation for the treatment of vasovagal syncope. Present and prospects
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https://orcid.org/0000-0003-1598-4471
Abstract
The aim – considering worldwide experience, it is necessary to analyze scientific articles about ablation of ganglion plexi (GP) (cardioneuroabaltion) for patients with vasovagal syncope (VVS).
Searching scientific articles was performed with well-known online-library PubMed. 203 articles were found in different scientific journals. The selection of patients is an essential factor during preprocedural period in order to predict results of cardioneuroablation. Ablation of ganglion plexi in both right and left atrium has showed the best effectiveness. Moreover, extracardiac vagal stimulation may be an advanced method to check acute results after parasympathetic denervation.
The first article about treatment of VVS has been published by Pachon et al. in 2005, that presented the reduced rate of recurrent syncope after cardioneuroabaltion. Results of the first randomized clinical trial have been published by R. Piotrowski et al., in which 48 patients were enrolled and were divided into two groups of 24 patients respectively. Group, where cardioneuroablation was performed, has the decreased level of the recurrence syncope in contrast with group, where conservative therapy was introduced (8 % and 54 % respectively). The first randomized clinical trial comparing clinical impact between pacemaker implantation and cardioneuroablation have being started in 2024 (TELE-SPACER).
Conclusions. The choosing of the appropriate method of treatment in patients with VVS is still discussed. Cardineuroablation may be become an effective and safe option especially in young people.
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References
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