Cardiac autonomic denervation. A novel approach to the treatment of bradyarrhythmias

Authors: Serguladze S.Yu., Matsonashvili G.R., Kulumbegov G.R.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

UDC: 616.12-008.318
DOI: https://doi.org/10.24022/1810-0694-2022-23-6-606-615

Cite as: Serguladze S.Yu., Matsonashvili G.R., Kulumbegov G.R. Cardiac autonomic denervation. A novel approach to the treatment of bradyarrhythmias. The Bulletin of Bakoulev Center. Cardiovascular Diseases. 2022; 23 (6): 606–15 (in Russ.). DOI: 10.24022/1810-0694-2022-23-6-606-615

Received / Accepted: 12.09.2022 / 02.11.2022

Keywords: cardioneuroablation sinus node dysfunction atrioventricular block vasovagal syncope

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Abstract

There are several clinical conditions in which dysfunction of the autonomic nervous system with an increased parasympathetic tone may result in sinus node disease or impaired conduction via the atrioventricular junction. Such patients, commonly of young age, are symptomatic and require permanent pacemaker implantation. Cardioneuroablation is an alternative method for management of patients with excessive vagal tone, supposing catheter radiofrequency ablation of main cardiac parasympathetic ganglia. Cardioneuroablation simulates the M-cholinolytic effect on the heart, it can be used in patients with vagally mediated bradyarrhythmias and vasovagal syncope. The target groups are patients with the functional rhythm and conduction disorders, therefore, the key to effectiveness is a careful selection of candidates for the procedure with verification of a sufficient "functional reserve". This review examines the basics of the cardioneuroablation, field of application, methods for detecting and mapping parasympathetic ganglia, advantages and disadvantages, as well as trends for the development.

References

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About the authors

Sergey Yu. Serguladze, Dr. Med. Sci., Head of Department; ORCID
Georgiy R. Matsonashvili, Cand. Med. Sci., Cardiovascular Surgeon; ORCID
Georgiy R. lKuumbegov, Postgraduate; ORCID

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Chief Editor

Elena Z. Golukhova, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery

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