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心律失常的导管消融治疗:从过去到未来。

Catheter Ablation of Bradyarrhythmia: From the Beginning to the Future.

机构信息

Department of Cardiology, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey.

Department of Cardiology, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey.

出版信息

Am J Med Sci. 2018 Mar;355(3):252-265. doi: 10.1016/j.amjms.2017.11.016. Epub 2017 Dec 1.

Abstract

Enhanced parasympathetic tone may cause sinus bradycardia or pauses, transient or permanent atrioventricular block, with resultant vasovagal syncope. A substantial portion of these patients may be highly symptomatic and refractory to the conventional therapies and may require cardiac pacemaker implantation. Cardioneuroablation is a little known technique for management of patients with excessive vagal activation based on radiofrequency catheter ablation of main parasympathetic autonomic ganglia around the heart. Due to complicated inclusion criteria, ganglia detection methods, and ablation endpoints, routine usage of the procedure cannot be recommended at this time. In this comprehensive review, we aimed to discuss all aspects of cardioneuroablation procedure in bradyarrhythmias.

摘要

增强的副交感神经活动可能导致窦性心动过缓或停搏、一过性或永久性房室传导阻滞,进而导致血管迷走性晕厥。这些患者中有相当一部分可能症状明显且对常规治疗方法无反应,可能需要植入心脏起搏器。心脏神经消融术是一种鲜为人知的技术,用于治疗过度迷走神经激活的患者,其基于心脏周围主要副交感自主神经节的射频导管消融。由于纳入标准复杂、神经节检测方法和消融终点不同,目前不能推荐常规使用该程序。在这篇全面的综述中,我们旨在讨论心脏神经消融术在缓慢性心律失常中的各个方面。

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