Abstract：
:Syncope is frequently neurally mediated and can seriously affect quality of life. Different ablation strategies have been successfully performed. These approaches have not gained wide acceptance and are quite extensive and complex, exposing patients to significant risks. This article reports the case of a 16-year-old girl who was severely affected by frequent and prolonged episodes of syncope and was treated by tailored ablation of the anterior right ganglionated plexus with a multielectrode irrigated catheter. She had fainted >30 times in the 5 years preceding treatment, experiencing approximately 10 severe episodes of syncope in the previous 12 months. After 3 minutes of ablation, the P-P interval was reduced by >400 milliseconds. Syncope disappeared and the patient has remained completely asymptomatic over a follow-up of 22 months. The "reset" basal P-P interval has remained unchanged (follow-up electrocardiogram at 16 months). At 6 months, there was no residual heart rate activity <50 bpm. On 24-hour rhythm registration, P-P intervals ≥1,000 milliseconds (corresponding to a heart rate of ≤60 bpm) were reduced by >16,000 beats. We believe that this case report is original for several reasons: the unusual clinical presentation; the unique structure targeted; the very limited ablation, implying much lower risks for the patient; the anatomical approach; and the different endpoint. This new "cardio-neuromodulation" approach could be useful for the treatment of patients with neurally mediated syncope.
journal_name
J Cardiovasc Electrophysioljournal_title
Journal of cardiovascular electrophysiologyauthors
Debruyne Pdoi
10.1111/jce.13031subject
Has Abstractpub_date
2016-09-01 00:00:00pages
1110-3issue
9eissn
1045-3873issn
1540-8167journal_volume
27pub_type
abstract：:Macro-Reentrant ARVC epi-VT with a Focal Endo-Activation. A 55-year-old man with arrhythmogenic right ventricular cardiomyopathy underwent catheter ablation of ventricular tachycardia (VT) with left bundle branch block and left superior axis QRS morphology with an early precordial transition. Endocardial mapping durin...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 杂志文章
doi：10.1111/j.1540-8167.2008.01395.x
更新日期：2009-06-01 00:00:00
abstract：INTRODUCTION:Acute myocardial ischemia, which opens K(ATP) channel, is associated with shortened action potential duration (APD) but prolonged QT interval. This discrepancy has not been adequately explained. We hypothesize that the duration of intracellular calcium (Ca(i)) transient (DCaT) may play a role in determinin...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 杂志文章
doi：10.1111/j.1540-8167.2005.40811.x
更新日期：2005-08-01 00:00:00
abstract：INTRODUCTION:The nature of the atrial substrate thought to contribute toward maintaining atrial fibrillation (AF) outside the pulmonary veins remains poorly defined. Therefore, our objective was to determine whether patients with paroxysmal and persistent AF have an abnormal electroanatomic substrate within the left at...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 杂志文章
doi：10.1111/j.1540-8167.2011.02178.x
更新日期：2012-03-01 00:00:00
abstract：BACKGROUND:Esophageal injury during left atrial ablation is associated with a significant risk of mortality and morbidity. There are no validated approaches to reduce injury outside of avoidance, a strategy critically dependent on a precise understanding of the esophageal anatomy and location. Intracardiac ultrasound (...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 杂志文章
doi：10.1111/j.1540-8167.2012.02441.x
更新日期：2013-01-01 00:00:00
abstract：:A 39-year-old woman with no structural heart disease and frequent episodes of sudden onset palpitations was referred for the electrophysiological study. During the study, a slightly irregular narrow QRS tachycardia with AV dissociation was repeatedly induced and spontaneously terminated. Apparently, irregular cycles a...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 杂志文章
doi：10.1111/jce.12026
更新日期：2013-03-01 00:00:00
abstract：BACKGROUND:The incidence of atrial fibrillation (AF) in heart transplant patients has not been well documented. METHODS:To determine the incidence of AF in a cohort of patients undergoing cardiac transplantation, clinical data were obtained from a prospectively collected database for all consecutive orthotopic heart t...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 杂志文章
doi：10.1111/j.1540-8167.2006.00497.x
更新日期：2006-08-01 00:00:00
abstract：INTRODUCTION:Anatomic and electrical connections between the left atrium and right atrium (RA) have been described. The relationship between coronary sinus (CS) pacing site and RA activation has not been examined. METHODS AND RESULTS:Fifteen anesthetized swine underwent high-density noncontact mapping of the RA during...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 杂志文章
doi：10.1046/j.1540-8167.2002.00794.x
更新日期：2002-08-01 00:00:00
abstract：BACKGROUND:Radiofrequency high-power ablation appears to be a novel concept for atrial fibrillation (AF). The ablation index (AI) value has been associated with durability of pulmonary vein isolation (PVI). OBJECTIVES:This study aimed to report the procedural data and initial results of a combined ablation technique u...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 杂志文章
doi：10.1111/jce.14219
更新日期：2019-12-01 00:00:00
abstract：INTRODUCTION:The relationship between the determining factors and beating rates of pulmonary vein (PV) pacemaker cardiomyocytes has not been fully elucidated. The purposes of this study were to compare the electrophysiological characteristics between PV fast and slow pacemaker cardiomyocytes. METHODS:Whole-cell patch ...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 杂志文章
doi：10.1111/j.1540-8167.2009.01480.x
更新日期：2009-09-01 00:00:00
abstract：INTRODUCTION:Although premature beats originating in areas of ischemia have been shown to be important in initiating ventricular fibrillation (VF), the participation of the ischemic zone in maintenance of VF has not been investigated. METHODS AND RESULTS:Ten normal dogs underwent induction of two separate episodes of ...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 杂志文章
doi：10.1111/j.1540-8167.1999.tb00282.x
更新日期：1999-08-01 00:00:00
abstract：:Calcium/calmodulin-dependent kinase II (CaMKII) is a multifunctional serine/threonine kinase widely distributed in a number of tissue types. Activation of CaMKII has been linked to important downstream physiological processes, including apoptosis, hypertrophy, and arrhythmia in the heart. Pharmacological or genetic in...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 杂志文章
doi：10.1111/j.1540-8167.2008.01295.x
更新日期：2008-12-01 00:00:00
abstract：:Due to the growing number of patients treated with cardiac implantable electronic devices (CIEDs) there is an increased need for lead management, evaluation, and extraction. While CIED lead extraction has many indications, a consistent approach to preprocedural planning should be applied in all cases, including a thor...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 杂志文章,评审
doi：10.1111/jce.14244
更新日期：2020-07-01 00:00:00
abstract：INTRODUCTION:This study investigated a hybrid approach to reduce the atrial defibrillation threshold (ADFT) by determining the effect of a single linear radiofrequency ablation (RFA) lesion on both the ADFT and activation patterns during atrial fibrillation (AF). METHODS AND RESULTS:In 18 open chest sheep (45 to 57 kg...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 杂志文章
doi：10.1046/j.1540-8167.2001.00463.x
更新日期：2001-04-01 00:00:00
abstract：INTRODUCTION:Atrial fibrillation (AF) in the left atrium (LA) is poorly defined in terms of regional differences in the degree of organization, characteristics of paroxysmal and persistent variants, and electrophysiologic events that develop at the onset of episodes. METHODS AND RESULTS:The study population consisted ...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 杂志文章
doi：10.1046/j.1540-8167.2002.00525.x
更新日期：2002-06-01 00:00:00
abstract：INTRODUCTION:How cell-to-cell electrical coupling influences an antiarrhythmic agent's effect on conduction is largely unknown. To investigate this, we evaluated the effects of procainamide on myocardial conduction at decreasing degrees of cell-to-cell electrical coupling induced by graded doses of heptanol. METHODS A...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 杂志文章
doi：10.1111/j.1540-8167.1997.tb00781.x
更新日期：1997-02-01 00:00:00
abstract：BACKGROUND:The reliable endpoint for ablation of longstanding persistent atrial fibrillation (LPAF) has not been clearly established. METHODS AND RESULTS:This study included 140 patients who underwent catheter ablation for drug-refractory LPAF. A stepwise ablation approach included circumferential pulmonary vein isola...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 杂志文章
doi：10.1111/j.1540-8167.2012.02370.x
更新日期：2012-10-01 00:00:00
abstract：INTRODUCTION:A novel magnetic navigation system allows remote guidance of floppy radiofrequency (RF) ablation catheters. We evaluated the feasibility of mapping and ablation of left-sided accessory pathways (APs) using the retrograde transaortic approach with this system. This might open the gate to retrograde ablation...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 临床试验,杂志文章
doi：10.1111/j.1540-8167.2007.00783.x
更新日期：2007-05-01 00:00:00
abstract：:There is an increasing need for invasive electrophysiologists to appreciate the exact anatomy of the epicardial space and the coronary veins. The location of the epicardial fat, the complementary relationship with the main cardiac veins, and the location of sensitive structures (arteries, phrenic nerve, esophagus) hav...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 杂志文章,评审
doi：10.1111/j.1540-8167.2010.01872.x
更新日期：2010-12-01 00:00:00
abstract：BACKGROUND:AF can be induced by RAP or ISO in >85% of patients with PAF. METHODS:ISO was administered in escalating doses of 5, 10, 15, and 20 microg/min in 112 patients (age = 56 +/- 13 years) with PAF before radiofrequency catheter ablation. AF was inducible in 97 of 112 patients (87%) at a mean dose of 15 +/- 5 mic...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 杂志文章
doi：10.1111/j.1540-8167.2009.01571.x
更新日期：2010-01-01 00:00:00
abstract：INTRODUCTION:Cardiac resynchronization therapy implants entail significant radiation exposure for patients and physicians. A novel 3D electromagnetic cardiovascular navigation system (MediGuide™) was designed to superimpose the real-time location of sensors embedded in delivery tools on prerecorded coronary sinus (CS) ...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 杂志文章
doi：10.1111/jce.12290
更新日期：2014-01-01 00:00:00
abstract：:Application of radiofrequency energy to arrhythmogenic substrates after careful cardiac mapping could ensure a high success rate in eliminating certain types of tachyarrhythmias. Future studies of catheter ablation will focus on how to improve ablation efficacy and achieve a better result in various types of tachyarrh...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 杂志文章,评审
doi：10.1111/j.1540-8167.1995.tb00360.x
更新日期：1995-10-01 00:00:00
abstract：INTRODUCTION:Epicardial procedures frequently require pericardial manipulation. We aimed to develop a nonsurgical percutaneous pericardial modification tool that may (1) facilitate epicardial-based procedures by enabling adhesiolysis or (2) attenuate the myocardial constraining effect of the pericardium. METHODS:Three...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 杂志文章
doi：10.1111/jce.13108
更新日期：2017-03-01 00:00:00
abstract：INTRODUCTION:Studies suggest that entrainment response (ER) of reentrant tachycardia to overdrive pacing can be estimated using signals from sites other than the paced site. METHODS AND RESULTS:A formula for estimation of ER using remote sites against the difference between the postpacing interval (PPI) and tachycardi...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 杂志文章
doi：10.1046/j.1540-8167.2003.02105.x
更新日期：2003-01-01 00:00:00
abstract：:Myasthenia gravis is an autoimmune disorder of the nervous system typically mediated by antibodies against the nicotinic acetylcholine receptor at the neuromuscular junction. Treatment of myasthenia gravis frequently involves the use of cholinesterase inhibitors such as pyridostigmine. Treatment with these agents has ...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 杂志文章
doi：10.1111/j.1540-8167.2007.00938.x
更新日期：2008-02-01 00:00:00
abstract：INTRODUCTION:We sought to explore the relationship between ventricular tachycardia (VT) and premature ventricular complex (PVC) burden (from implantable cardioverter-defibrillator diagnostics), before and during corticosteroid use in patients with newly diagnosed clinically manifest cardiac sarcoidosis (CS). METHODS:A...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 杂志文章
doi：10.1111/jce.14689
更新日期：2020-10-01 00:00:00
abstract：INTRODUCTION:It is the hypothesis of this article that the onset of fibrillation following a coronary artery occlusion is a direct consequence of the spatial inhomogeneity of chemical processes that occur following the occlusion. In particular, the localized increase of extracellular potassium and decrease of ATP avail...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 杂志文章
doi：10.1046/j.1540-8167.2003.03045.x
更新日期：2003-11-01 00:00:00
abstract：INTRODUCTION:Heart failure patients with left ventricular assist devices (LVADs) are at risk for infection. Cardiac implantable electronic devices (CIEDs) are commonly present in these patients. The course of infections in patients with an LVAD and a CIED is not well described. METHODS AND RESULTS:We identified 6 pati...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 杂志文章
doi：10.1111/jce.12461
更新日期：2014-11-01 00:00:00
abstract：:Despite many years of research, the mechanisms of atrial fibrillation (AF) are still poorly understood, and we currently are unable to adequately treat most patients with AF. Recently, the demonstration in both human and animal studies that the pulmonary veins (PVs) and the posterior left atrial (LA) wall play a subst...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 杂志文章,评审
doi：10.1046/j.1540-8167.2003.03136.x
更新日期：2003-07-01 00:00:00
abstract：INTRODUCTION:Patients with bradycardia requiring permanent pacing frequently suffer from additional atrial tachyarrhythmias (ATs). This study evaluated the safety and efficacy of atrial antitachycardia pacing (ATP) and the performance of pacing for AT prevention implemented into a new pacemaker. METHODS AND RESULTS:In...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 临床试验,杂志文章,多中心研究
doi：10.1046/j.1540-8167.2001.01121.x
更新日期：2001-10-01 00:00:00
abstract：:Epicardial RFA to Achieve Electrical PV Isolation. During catheter ablation of atrial fibrillation, ablation within the pulmonary veins is undesirable due to the risk of pulmonary venous stenosis and the possibility of leaving residual cuffs of arrhythmogenic tissue proximal to the ablation lesion set. An extra-ostial...
journal_title：Journal of cardiovascular electrophysiology
pub_type： 杂志文章
doi：10.1046/j.1540-8167.2003.03049.x
更新日期：2003-06-01 00:00:00
