Clinical controversy : methodology and indications of cardioneuroablation for reflex syncope
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F23%3A00083982" target="_blank" >RIV/00023001:_____/23:00083982 - isvavai.cz</a>
Alternative codes found
RIV/00216208:11110/23:10465168
Result on the web
<a href="https://academic.oup.com/europace/article/25/5/euad033/7109342?login=true" target="_blank" >https://academic.oup.com/europace/article/25/5/euad033/7109342?login=true</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1093/europace/euad033" target="_blank" >10.1093/europace/euad033</a>
Alternative languages
Result language
angličtina
Original language name
Clinical controversy : methodology and indications of cardioneuroablation for reflex syncope
Original language description
In 2005, Pachon et al. proposed cardiac vagal denervation to treatneurally mediated syncope. Since then, a metanalysis of observationalstudies and a recent randomized controlled trial (RCT) have provided some evidence that cardioneuroablation (CNA) is able to prevent syncope recurrence at least during the first 2 years following theprocedure in patients affected by reflex syncope. In brief, the recentmetanalysis of 14 studies including a total of 465 patients reportedan average freedom of syncopal recurrence in 92% of patients (95%confidence interval 88–95%) during follow-up. The only availableopen RCT3 reported 8% recurrence of syncope in the 24 patients randomized to CNA and 54% recurrence rate in 24 untreated controls(P = 0.0004) during 2-year follow-up. In all studies, after the ablationprocedure, the patients demonstrated heart rate increase togetherwith reduction of heart rate variability (indicating impaired parasympathetic stimulation of the heart) persisting at least for 2 years. Thisprovides proof-of-concept for the modification of the vagal ganglia activity in the heart.Given these facts, it is likely that CNA will become increasinglypopular among physicians caring for syncope patients in the yearsto come. Nevertheless, many issues concerning clinical indications,methodology, and long-term results remain unresolved. These issues constitute the background of this manuscript in which leadersin CNA and experts in syncope debated critical issues and aimed tofind agreement and, if not possible, to highlight the controversiesthat could be addressed in future studies. The authors were initiallyrequested to give their evidence-based opinion on several predefined motions. These were merged into a manuscript draft, whichwas subsequently critically revised by means of two rounds ofcomments.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
—
OECD FORD branch
30201 - Cardiac and Cardiovascular systems
Result continuities
Project
—
Continuities
N - Vyzkumna aktivita podporovana z neverejnych zdroju
Others
Publication year
2023
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Europace
ISSN
1099-5129
e-ISSN
1532-2092
Volume of the periodical
25
Issue of the periodical within the volume
5
Country of publishing house
GB - UNITED KINGDOM
Number of pages
10
Pages from-to
"art. no. euad033"
UT code for WoS article
000963587100001
EID of the result in the Scopus database
2-s2.0-85160870300