Marrese A, Persico R, Parlato E, Faccenda D, Salucci A, Comparone G, Pergola V, Ammirati G, Addeo L, Fonderico C, Cocchiara L, Volpe A, Visconti P, Rapacciuolo A, Strisciuglio T
Department of Cardiology, University of Naples Federico II, Naples, Italy.
Front Cardiovasc Med. 2024 Jul 26;11:1412195. doi: 10.3389/fcvm.2024.1412195. eCollection 2024.
Cardioneuroablation (CNA) is a novel interventional procedure for the treatment of recurrent vasovagal syncope (VVS) and advanced atrioventricular block secondary to hyperactivation of vagal tone in young patients. By damaging the cardiac parasympathetic ganglia, CNA seems to be able to mitigate and/or abolish the excessive vagal activity and improve patients' outcome. This review is intended to give a detailed and comprehensive overview of the current evidences regarding (1) the clinical applications of CNA (2) the identification of ablation targets and procedural endpoints (3) the medium-long term effect of the procedure and its future perspectives. However, clinical data are still limited, and expert consensus or recommendations in the guidelines regarding this technique are still lacking.
心脏神经消融术(CNA)是一种新型介入治疗方法,用于治疗年轻患者复发性血管迷走性晕厥(VVS)以及继发于迷走神经张力亢进的晚期房室传导阻滞。通过破坏心脏副交感神经节,CNA似乎能够减轻和/或消除过度的迷走神经活动,并改善患者预后。本综述旨在对目前有关以下方面的证据进行详细而全面的概述:(1)CNA的临床应用;(2)消融靶点的识别和手术终点;(3)该手术的中长期效果及其未来前景。然而,临床数据仍然有限,并且指南中关于该技术的专家共识或建议仍然缺乏。