Medium-term results of cardioneuroablation for clinical bradyarrhythmias and vasovagal syncope: effects on QT interval and heart rate


Aksu T., Guler T. E., Bozyel S., Golcuk S. E., Yalin K., Lakkireddy D., ...More

JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY, vol.60, no.1, pp.57-68, 2021 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 60 Issue: 1
  • Publication Date: 2021
  • Doi Number: 10.1007/s10840-020-00704-2
  • Journal Name: JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Agricultural & Environmental Science Database, CINAHL, EMBASE, MEDLINE
  • Page Numbers: pp.57-68
  • Keywords: Atrial fibrillation, Atrioventricular block, Bradycardia, Ganglionated plexi, QT interval, Syncope
  • Istanbul University Affiliated: No

Abstract

Purpose Although parasympathetic effects of cardioneuroablation (CNA) in vagally mediated bradyarrhythmias (VMB) were studied, sympathetic effects have not been elucidated, yet. We aimed to investigate the acute and medium-term outcomes of CNA as well as the impact of CNA on ventricular repolarization by using corrected QT interval (QTc) measurements. Methods Sixty-five patients (58.5% men; age 39.4 +/- 14 years) undergoing CNA were included in the study. Patients who underwent CNA due to VMB were divided into two groups: (1) bi-atrial CNA and (2) right-sided CNA. QTc was calculated at 3 time points: before the procedure (time point 1); 24 h post-ablation (time point 2); and at the last follow-up visit (time point 3). Results The mean follow-up time was 20.0 +/- 20 months. Acute success was achieved in 64 (98.4%) of cases. In the whole cohort, from time point 1 to 2, a significant shortening in QTcFredericia, QTcFramingham, and QTcHodges was observed which remained lower than baseline in time point 3. Although the difference between measurements in time point 1 and 2 was not statistically significant for QTcBazett, a significant shortening was detected between time point 1 and 3. There was significant difference between groups for shortening in QTcFredericia and QTcFramingham (p = 0.01). Event-free survival was detected in 90.7% (59/65) of cases. Conclusions Our results demonstrate a significant shortening of QTc in addition to high acute and medium-term success rates after CNA. The most likely mechanism is the effect of CNA on the sympathetic system as well as on the parasympathetic system. Bi-atrial ablation was found related to higher QTc shortening effect.