针对右侧肺门肿瘤继发难治性血管迷走性晕厥的心脏神经消融术。
Cardioneuroablation for Refractory Vasovagal Storm Secondary to a Right Hilar Tumor.
作者信息
Abu-Alrub Saer, Tronchi Allan, Boudias Antoine, Jean Frédéric, Catalan Pierre-Antoine, Eschalier Romain, Massoullié Grégoire
机构信息
Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France.
Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France.
出版信息
JACC Case Rep. 2025 Sep 3;30(26):104932. doi: 10.1016/j.jaccas.2025.104932.
BACKGROUND
Cardiac syncope due to sinus arrest may result from either a vasovagal cardioinhibitory mechanism or an intrinsic sinus node dysfunction.
CASE SUMMARY
A 67-year-old woman with a recently diagnosed right hilar mass presented with new-onset episodes of syncope associated with sinus arrest. Resting electrocardiogram was normal, and no electrolyte abnormalities were identified. Detailed analysis of telemetry recordings revealed a typical vasovagal cardioinhibitory response. The patient underwent a cardioneuroablation procedure. Since the procedure, there has been no recurrence of syncope or evidence of sinus pause.
DISCUSSION
A vasovagal cardioinhibitory response may be triggered by mechanical compression of the vagus nerve or ganglionated plexi. Cardioneuroablation represents a valuable alternative to permanent pacemaker implantation and should be considered in appropriately selected patients.
TAKE-HOME MESSAGE: This case highlights the diagnostic telemetry features of vasovagal cardioinhibitory response in an unusual cause of vasovagal syncope, guiding appropriate management with cardioneuroablation.
背景
窦性停搏所致的心源性晕厥可能由血管迷走神经抑制机制或窦房结内在功能障碍引起。
病例摘要
一名67岁女性，近期诊断为右肺门肿块，出现与窦性停搏相关的新发晕厥发作。静息心电图正常，未发现电解质异常。对遥测记录的详细分析显示为典型的血管迷走神经抑制反应。该患者接受了心脏神经消融术。自手术以来，未再出现晕厥复发或窦性停搏的证据。
讨论
血管迷走神经抑制反应可能由迷走神经或神经节丛的机械压迫触发。心脏神经消融术是永久起搏器植入的一种有价值的替代方法，应在适当选择的患者中考虑。
要点
本病例突出了血管迷走性晕厥不寻常病因中血管迷走神经抑制反应的诊断遥测特征，指导心脏神经消融术的适当管理。
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