Potential consequences of cardioneuroablation for vasovagal syncope : A call for appropriately designed, sham-controlled clinical trials
Copyright © 2023 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved..
Cardioneuroablation (CNA) is being increasingly used to treat patients with vasovagal syncope (VVS). Bradycardia, in the cardioinhibitory subtype of VVS, results from transient parasympathetic overactivity leading to sinus bradycardia and/or atrioventricular block. By mitigating parasympathetic overactivity, CNA has been shown to improve VVS symptoms in clinical studies with relatively small sample sizes and short follow-up periods (<5 years) at selected centers. However, CNA may potentially tip the autonomic balance to a state of sympathovagal imbalance with attenuation of cardiac parasympathetic activity. A higher heart rate is associated with adverse cardiovascular events and increased mortality in healthy populations without cardiovascular diseases. Chronic sympathovagal imbalance may also affect the pathophysiology of spectra of cardiovascular disorders including atrial and ventricular arrhythmias. This review addresses potential long-term pathophysiological consequences of CNA for VVS.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:21 |
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| Enthalten in: |
Heart rhythm - 21(2024), 4 vom: 15. Apr., Seite 464-470 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Chakraborty, Praloy [VerfasserIn] |
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| Links: |
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| Themen: |
Autonomic denervation |
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| Anmerkungen: |
Date Completed 01.04.2024 Date Revised 01.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.hrthm.2023.12.004 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM36595652X |
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| 520 | |a Copyright © 2023 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a Cardioneuroablation (CNA) is being increasingly used to treat patients with vasovagal syncope (VVS). Bradycardia, in the cardioinhibitory subtype of VVS, results from transient parasympathetic overactivity leading to sinus bradycardia and/or atrioventricular block. By mitigating parasympathetic overactivity, CNA has been shown to improve VVS symptoms in clinical studies with relatively small sample sizes and short follow-up periods (<5 years) at selected centers. However, CNA may potentially tip the autonomic balance to a state of sympathovagal imbalance with attenuation of cardiac parasympathetic activity. A higher heart rate is associated with adverse cardiovascular events and increased mortality in healthy populations without cardiovascular diseases. Chronic sympathovagal imbalance may also affect the pathophysiology of spectra of cardiovascular disorders including atrial and ventricular arrhythmias. This review addresses potential long-term pathophysiological consequences of CNA for VVS | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
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| 650 | 4 | |a Cardioneuroablation | |
| 650 | 4 | |a Parasympathetic activity | |
| 650 | 4 | |a Sympathetic overdrive | |
| 650 | 4 | |a Vasovagal syncope | |
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| 700 | 1 | |a Gollob, Michael H |e verfasserin |4 aut | |
| 700 | 1 | |a Olshansky, Brian |e verfasserin |4 aut | |
| 700 | 1 | |a Po, Sunny S |e verfasserin |4 aut | |
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