Clinical controversy : methodology and indications of cardioneuroablation for reflex syncope

Kód výsledku v 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>

Nalezeny alternativní kódy

RIV/00216208:11110/23:10465168

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

Clinical controversy : methodology and indications of cardioneuroablation for reflex syncope

Popis výsledku v původním jazyce

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.

Název v anglickém jazyce

Clinical controversy : methodology and indications of cardioneuroablation for reflex syncope

Popis výsledku anglicky

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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Rok uplatnění

2023

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Europace

ISSN

1099-5129

e-ISSN

1532-2092

Svazek periodika

25

Číslo periodika v rámci svazku

5

Stát vydavatele periodika

GB - Spojené království Velké Británie a Severního Irska

Počet stran výsledku

10

Strana od-do

"art. no. euad033"

Kód UT WoS článku

000963587100001

EID výsledku v databázi Scopus

2-s2.0-85160870300