Cardioneuroablation For the Treatment of Reflex Syncope and Functional Bradyarrhythmias: What We Learned From the EHRA/HRS/LAHRS Document (Joint Session) (non-ACE)-Cardioneuroablation For the Treatment of Reflex Syncope and Functional Bradyarrhythmias: What We Learned From the EHRA/HRS/LAHRS Document (Joint Session) (non-ACE)

Cardioneuroablation For the Treatment of Reflex Syncope and Functional Bradyarrhythmias: What We Learned From the EHRA/HRS/LAHRS Document (Joint Session) (non-ACE)

Video Transcription

Video Summary

The session titled "Cardioneuroablation for the Treatment of Reflex Syncope and Functional Bradyarrhythmias" discusses various aspects of cardioneuroablation (CNA) in treating reflex syncope and bradyarrhythmias. The opening presentation by Dr. Varsaghi focuses on the anatomy and physiology of the cardiac autonomic nervous system, emphasizing the nerve fibers' intricate network around the heart, including the vagus nerve's pivotal role. Dr. Varsaghi explains that cardioneuroablation targets specific ganglionic plexi (GP) to impact autonomic control of the heart. <br /><br />Dr. Pichone from Sao Paulo University presents clinical evidence supporting CNA, arguing it is ready for prime time for patients who do not respond to other treatments. He highlights the historical development of CNA, showcasing its efficacy in treating vagally mediated arrhythmias but emphasizes the need for careful patient selection, often using extracardiac vagal stimulation to guide the procedure.<br /><br />Dr. Agudelo shares a case focusing on younger patients with functional AV block, illustrating CNA's potential to be an alternative to pacemakers. The case highlights CNA's promise but also underscores the need for robust clinical trials and careful monitoring.<br /><br />Finally, Dr. Wick-Terle discusses the known and possible risks of CNA, noting the significant decrease in post-procedure heart rate variability and the lack of long-term adverse effects in this patient population. The consensus is that while CNA shows promise, particularly as a curative approach, patient selection and cautious implementation are crucial, given the procedural complexity and potential complications.

Keywords

Cardioneuroablation

Reflex Syncope

Functional Bradyarrhythmias

Cardiac Autonomic Nervous System

Vagus Nerve

Ganglionic Plexi

Clinical Evidence

Extracardiac Vagal Stimulation

Functional AV Block

Pacemaker Alternative

Heart Rate Variability