无荧光透视功能性心动过缓心脏神经消融术：单中心经验
Fluoroscopy-free cardioneuroablation for functional bradycardia: a single-center experience.
作者信息
Choubdar Parnia Abolhassan, Gruber Megan, Pachon-M Jose Carlos, Manu Stephen, Razminia Mansour, Clark John
机构信息
Department of Medicine, University of Kentucky, Bowling Green, KY, USA.
Department of Cardiovascular Disease, Metrohealth Medical Center, Cleveland, OH, USA.
出版信息
J Interv Card Electrophysiol. 2025 Mar;68(2):443-453. doi: 10.1007/s10840-024-01926-4. Epub 2024 Oct 10.
BACKGROUND
Cardioneuroablation (CNA) is an emerging treatment for cardioinhibitory syncope and functional AV block. This study aimed to evaluate the safety and efficacy of a fluoroless CNA approach using three-dimensional mapping and extracardiac vagal stimulation (ECVS).
METHODS
This prospective observational study included 22 patients (mean age 21 years) with clinically significant functional bradycardia who underwent fluoroless CNA. Procedural success was defined as elimination or significant attenuation of the vagal response to ECVS.
RESULTS
CNA was successfully performed in all patients with a mean procedure time of 251 min. Fluoroscopy was avoided in 91% of cases. At a mean follow-up of 11.4 months, 77% of patients remained symptom-free. Among pacemaker patients, 90% did not require further pacing, and 6/10 (60%) have had their pacemakers turned off. No complications were seen during the procedure.
CONCLUSIONS
Fluoroscopy-free CNA is a safe and effective treatment for functional bradycardia, offering high procedural success rates and favorable symptom-free outcomes while minimizing radiation exposure.
背景
心脏神经消融术（CNA）是一种针对心脏抑制性晕厥和功能性房室传导阻滞的新兴治疗方法。本研究旨在评估使用三维标测和心外迷走神经刺激（ECVS）的无荧光CNA方法的安全性和有效性。
方法
这项前瞻性观察性研究纳入了22例（平均年龄21岁）患有具有临床意义的功能性心动过缓的患者，他们接受了无荧光CNA治疗。手术成功定义为迷走神经对ECVS的反应消除或显著减弱。
结果
所有患者均成功进行了CNA，平均手术时间为251分钟。91%的病例避免了使用荧光透视。平均随访11.4个月时，77%的患者无症状。在起搏器植入患者中，90%不再需要进一步起搏，10例中有6例（60%）已关闭起搏器。手术过程中未观察到并发症。
结论
无荧光CNA是治疗功能性心动过缓的一种安全有效的方法，手术成功率高，无症状结局良好，同时可将辐射暴露降至最低。
Zotero 插件