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心脏神经消融术治疗心脏停搏反射性晕厥:如何识别最佳候选患者以及如何预测成功率。

Cardioneuroablation for Asystolic Reflex Syncope: How to Identify the Best Candidate and How to Predict Success.

作者信息

Kulakowski Piotr

机构信息

Department of Cardiology, Medical Centre for Postgraduate Education, Grochowski Hospital Warsaw, Poland.

出版信息

Arrhythm Electrophysiol Rev. 2025 Aug 12;14:e17. doi: 10.15420/aer.2025.25. eCollection 2025.

DOI:10.15420/aer.2025.25
PMID:40918691
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12409729/
Abstract

Cardioneuroablation is a relatively new method to treat asystolic reflex syncope. The short- and mid-term efficacy ranges between 70% and 94%. Although the method is increasingly used worldwide, there are many unresolved issues associated with the use of this technique. One such issue is the correct identification of optimal candidates for cardioneuroablation. This article reviews the demographic, clinical and procedural parameters that may be of value in predicting the efficacy of cardioneuroablation.

摘要

心脏神经消融术是一种治疗无收缩期反射性晕厥的相对较新的方法。其短期和中期疗效在70%至94%之间。尽管该方法在全球范围内的使用越来越广泛,但与该技术的使用相关仍有许多未解决的问题。其中一个问题是正确识别心脏神经消融术的最佳候选者。本文综述了可能对预测心脏神经消融术疗效有价值的人口统计学、临床和手术参数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd77/12409729/17ebfd2d24bc/aer-14-e17-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd77/12409729/17ebfd2d24bc/aer-14-e17-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd77/12409729/17ebfd2d24bc/aer-14-e17-g001.jpg

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本文引用的文献

1
Efficacy of cardioneuroablation for vasodepressor vasovagal syncope.心脏神经消融术治疗血管抑制性血管迷走性晕厥的疗效
Front Neurosci. 2025 Apr 4;19:1514513. doi: 10.3389/fnins.2025.1514513. eCollection 2025.
2
The Efficacy of Left Atrial vs Biatrial Cardioneuroablation in Patients With Vasovagal Syncope: A Randomized Clinical Trial.血管迷走性晕厥患者左心房与双心房心脏神经消融术的疗效:一项随机临床试验
JACC Clin Electrophysiol. 2025 Jun;11(6):1265-1276. doi: 10.1016/j.jacep.2025.01.019. Epub 2025 Mar 19.
3
Catheter Ablation for Vasovagal Syncope: The Therapeutic Potential of Gateway Plexi.
血管迷走性晕厥的导管消融:门控神经丛的治疗潜力
Arrhythm Electrophysiol Rev. 2025 Jan 14;14:e01. doi: 10.15420/aer.2024.36. eCollection 2025.
4
A computed tomography-based evaluation and comparison of ganglionated plexus targeting techniques for cardioneuroablation.基于计算机断层扫描的心脏神经消融中神经节丛靶向技术的评估与比较
Heart Rhythm. 2025 Jan 16. doi: 10.1016/j.hrthm.2025.01.013.
5
Differential and synergistic effects of right and left atrial ganglionated plexi ablation in patients undergoing cardioneuroablation: results from the ELEGANCE multicenter study.心脏神经消融患者左右心房神经节丛消融的差异及协同效应:ELEGANCE多中心研究结果
J Interv Card Electrophysiol. 2025 Mar;68(2):195-202. doi: 10.1007/s10840-024-01968-8. Epub 2024 Dec 13.
6
Effect of age on clinical impact and mid-term denervation in patients undergoing cardioneuroablation.年龄对心神经消融术患者临床影响和中期去神经化的影响。
Sci Rep. 2024 Nov 11;14(1):27546. doi: 10.1038/s41598-024-78665-z.
7
Predictors of Clinical Success of Cardioneuroablation in Patients With Syncope: Results of a Multicenter Study.晕厥患者心脏神经消融临床成功的预测因素:一项多中心研究的结果
JACC Clin Electrophysiol. 2024 Dec;10(12):2711-2724. doi: 10.1016/j.jacep.2024.07.027. Epub 2024 Oct 23.
8
Fluoroscopy-free cardioneuroablation for functional bradycardia: a single-center experience.无荧光透视功能性心动过缓心脏神经消融术:单中心经验
J Interv Card Electrophysiol. 2025 Mar;68(2):443-453. doi: 10.1007/s10840-024-01926-4. Epub 2024 Oct 10.
9
Cardioneuroablation for the treatment of reflex syncope and functional bradyarrhythmias: A Scientific Statement of the European Heart Rhythm Association (EHRA) of the ESC, the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS) and the Latin American Heart Rhythm Society (LAHRS).心脏神经消融术治疗反射性晕厥和功能性心动过缓:欧洲心脏病学会心律协会 (EHRA)、心律学会 (HRS)、亚太心律学会 (APHRS) 和拉丁美洲心律学会 (LAHRS) 的科学声明。
Europace. 2024 Aug 3;26(8). doi: 10.1093/europace/euae206.
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Cardioneuroablation in patients with vasovagal syncope: An updated systematic review and meta-analysis.血管迷走性晕厥患者的心脏神经消融:一项更新的系统评价和荟萃分析。
Heart Rhythm. 2025 Feb;22(2):526-535. doi: 10.1016/j.hrthm.2024.07.103. Epub 2024 Jul 25.