Ao-SVC GP modification significantly increased mean heart rate (68.6 vs 56.6) and reduced syncope (p=0.032) in patients with vagal bradycardia and concurrent tachyarrhythmias.
Does right atrial superior vena cava-aorta ganglionated plexus (Ao-SVC GP) modification improve heart rate and reduce syncope in patients with PVCs or PSVT and vagal bradycardia?
Adding superior vena cava-aorta ganglionated plexus modification to conventional ablation for PVCs or PSVT significantly improves heart rate and reduces syncope in patients with concurrent vagal bradycardia.
Absolute Event Rate: 0% vs 0%
ABSTRACT Background Frequent premature ventricular contractions (PVCs) or paroxysmal supraventricular tachycardia (PSVT) in patients with bradyarrhythmia is difficult to treat. Cardioneuroablation (CNA) is now considered a promising treatment for vagally mediated bradyarrhythmia. Hypothesis Modifying the right atrial superior vena cava–aorta ganglionated plexus (Ao‐SVC GP) improves heart rate and prognosis in vagal bradycardia with tachyarrhythmias. Methods We enrolled 110 patients with PVCs or PSVT and vagal bradycardia who underwent catheter ablation. Patients were randomized into the CNA group ( n = 55) and the control group ( n = 55). All patients underwent a conventional electrophysiological examination and ablation of PVCs or PSVT. Next, we performed Ao‐SVC GP modification in patients in the CNA group. The primary endpoints included elevation of the basal HR (> 20%) and shortening of the Wenckebach cycle length (WCL) or the AH interval (> 20%). Results The immediate success rate of ablation of PVCs and PSVT in both groups was 100%. Compared with those in the control group, patients in the CNA group showed significant improvement in WCL, corrected sinus node recovery time (cSNRT), mean HR, minimum HR, and DC (404.55 ± 71.80 vs. 489.27 ± 85.63; 359.15 ± 52.29 vs. 409.34 ± 59.73; 68.58 ± 8.11 vs. 56.64 ± 4.15; 46.20 ± 4.67 vs. 41.27 ± 3.25; 5.38 (4.23, 6.32) vs. 8.88 (7.17, 9.93), respectively; p < 0.05). More importantly, the incidence of syncope in the CNA group was significantly lower ( p = 0.032 < 0.05), and the improvement in quality of life was greater and more extensive in the CNA group. Conclusion The simplified right atrial Ao‐SVC GP ablation effectively treats vagal bradycardia. Additionally, combining it with radiofrequency ablation for concurrent tachyarrhythmia offers a safe and innovative therapy.
Meng et al. (Tue,) reported a other. Ao-SVC GP modification significantly increased mean heart rate (68.6 vs 56.6) and reduced syncope (p=0.032) in patients with vagal bradycardia and concurrent tachyarrhythmias.