Centre of Postgraduate Medical Education, Department of Cardiology, Grochowski Hospital, Warsaw, Poland.
Centre of Postgraduate Medical Education, Department of Cardiology, Grochowski Hospital, Warsaw, Poland.
J Electrocardiol. 2021 Mar-Apr;65:1-2. doi: 10.1016/j.jelectrocard.2021.01.003. Epub 2021 Jan 9.
Experimental studies demonstrated a shift in the leading pacemaker site based on parasympathetic or sympathetic dominance. Radiofrequency catheter ablation of ganglionated plexi (GP) might be used to overcome deleterious effects of enhanced parasympathetic tone. Herein, we present two patients who underwent GP ablation due to cardioinhibitory type reflex syncope and symptomatic bradycardia, respectively. In both cases complete vagal denervation was achieved and was associated with a cranial shift of sinus node activation area with corresponding changes in surface P wave morphology. This unique phenomenon needs to be confirmed in the larger prospective study.
实验研究表明，根据副交感神经或交感神经优势，主导起搏部位发生转移。神经节丛（GP）射频导管消融术可能用于克服增强的副交感神经张力的有害影响。在此，我们介绍了两名分别因心脏抑制型反射性晕厥和症状性心动过缓而行 GP 消融术的患者。在这两种情况下，均实现了完全的迷走神经切断，并且与窦房结激活区的颅向移位以及相应的体表 P 波形态变化相关。这种独特的现象需要在更大的前瞻性研究中得到证实。
