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心脏神经消融术可作为治疗舌咽神经痛相关窦性心动过缓和停搏的有效策略。

Cardioneuroablation can be an effective strategy to treat glossopharyngeal neuralgia-related sinus bradycardia and pauses.

机构信息

Department of CV Medicine, Heart, Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, USA.

Department of Internal Medicine, Cleveland Clinic Akron General Hospital, Akron, Ohio, USA.

出版信息

J Cardiovasc Electrophysiol. 2024 Oct;35(10):2076-2080. doi: 10.1111/jce.16407. Epub 2024 Aug 19.

DOI:10.1111/jce.16407
PMID:39160775
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11703600/
Abstract

INTRODUCTION

Cardioneuroablation (CNA) has proven effectiveness in addressing hypervagotonia symptoms, such as neurocardiogenic syncope.

METHODS AND RESULTS

In this case, we present the first-time application of CNA in a case of vago-glossopharyngeal neuralgia (VGPN). A 59-year-old female with near-syncope, sinus bradycardia, and sinus pauses triggered by recurrent right-sided neck pain was diagnosed with VGPN. The patient underwent successful treatment with carbamazepine and CNA. Subsequent follow-up revealed the sustained absence of sinus bradycardia or pauses, even upon neck pain resurgence after discontinuing carbamazepine.

CONCLUSION

In this patient, CNA successfully prevented pauses associated with VGPN, avoiding permanent pacemaker implantation.

摘要

简介

心脏神经消融术（CNA）已被证明可有效治疗过度迷走神经张力相关症状，如神经心源性晕厥。

方法与结果

在本病例中，我们首次应用 CNA 治疗舌咽神经痛（VGPN）。一位 59 岁女性，因右侧颈部反复疼痛导致近乎晕厥、窦性心动过缓及窦性停搏，被诊断为 VGPN。患者在接受卡马西平及 CNA 治疗后症状得到缓解。后续随访发现，即使在停用卡马西平后颈部疼痛复发，窦性心动过缓和停搏也未再出现。

结论

在该患者中，CNA 成功预防了与 VGPN 相关的停搏，避免了永久性起搏器植入。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc9e/11703600/50c307a605a3/nihms-2045144-f0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc9e/11703600/aaadb25ab9bc/nihms-2045144-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc9e/11703600/c2cc10e4a89a/nihms-2045144-f0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc9e/11703600/50c307a605a3/nihms-2045144-f0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc9e/11703600/aaadb25ab9bc/nihms-2045144-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc9e/11703600/c2cc10e4a89a/nihms-2045144-f0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc9e/11703600/50c307a605a3/nihms-2045144-f0003.jpg

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本文引用的文献

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Glossopharyngeal neuralgia with cardioinhibitory syncope: Is a permanent pacemaker required?伴有心脏抑制性晕厥的舌咽神经痛：是否需要植入永久性起搏器？
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Permanent pacing versus cardioneuroablation for cardioinhibitory vasovagal syncope.永久性起搏与心脏神经消融术治疗心脏抑制型血管迷走性晕厥的比较
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Circ Arrhythm Electrophysiol. 2021 Sep;14(9):e010018. doi: 10.1161/CIRCEP.121.010018. Epub 2021 Sep 1.
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