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Efficacy of catheter ablation in ganglionated plexus for malignant vasovagal syncope children

Published online by Cambridge University Press:  04 April 2024

Hongxia Li ,
Wei Shao ,
Xia Yu ,
Lu Gao  and
Yue Yuan Open the ORCID record for Yue Yuan [Opens in a new window]
Hongxia Li
Affiliation:
Department of Cardiology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
Wei Shao
Affiliation:
Department of Cardiology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
Xia Yu
Affiliation:
Department of Cardiology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
Lu Gao
Affiliation:
Department of Cardiology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
Yue Yuan*
Affiliation:
Department of Cardiology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
*
Corresponding author: Y. Yuan; Email: yuanyuebj@126.com
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Abstract

Aim:

Malignant vasovagal syncope in children seriously affects their physical and mental health. Our study aimed to explore the efficacy of catheter ablation in ganglionated plexus with malignant vasovagal syncope children.

Conclusion:

Catheter ablation of ganglionated plexus was safe and effective in children with malignant vasovagal syncope and can be used as a treatment option for these children.

Methods:

A total of 20 children diagnosed with malignant vasovagal syncope were enrolled in Beijing Children’s Hospital, affiliated with Capital Medical University. All underwent catheter ablation treatment of ganglionated plexus. Ganglionated plexuses of the left atrium were identified by high-frequency stimulation and/or anatomic landmarks being targeted by radiofrequency catheter ablation. The efficacy of the treatment was evaluated by comparing the remission rate of post-operative syncopal symptoms and the rate of negative head-up tilt results. Safety and adverse events were evaluated.

Results:

After follow-up for 2.5 (0.6–5) years, the syncope symptom scores were decreased significantly compared with before treatment [3 (2–4) versus 5 (3–8) scores, P < 0.01]. Eighty-five per cent (17/20) children no longer experienced syncope, whilst 80% (16/20) children showed negative head-up tilt test after treatment. No adverse effects such as cardiac arrhythmia occurred in the children.

Keywords

Malignant vasovagal syncopecatheter ablationganglionated plexuschildren
Type
Original Article
Information
Cardiology in the Young , First View , pp. 1 - 6
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Copyright
© The Author(s), 2024. Published by Cambridge University Press

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References

Wang, Y, Wang, Y, He, B, et al. Plasma human growth cytokines in children with vasovagal syncope. Front Cardiovasc Med 2022; 9: 1030618.CrossRefGoogle ScholarPubMed
Zhang, Z, Jiang, X, Han, L, et al. Differential diagnostic models between vasovagal syncope and psychogenic pseudosyncope in children. Front Neurol 2019; 10: 1392. DOI: 10.3389/fneur.2019.01392.CrossRefGoogle ScholarPubMed
Task Force for the Diagnosis and Management of Syncope,European Society of Cardiology (ESC), European Heart Rhythm Association (EHRA). Guidelines for the diagnosis and management of syncope (version 2009). Eur Heart J 2009; 30: 2631–2671.CrossRefGoogle Scholar
Shen, WK, Sheldon, RS, Benditt, DG, Writing Committee Members, et al. ACC/AHA/HRS guideline for the evaluation and management of patients with syncope: a report of the American college of cardiology/American heart association task force on clinical practice guidelines and the heart rhythm society. Heart Rhythm 2017; 14: e155–e217.CrossRefGoogle Scholar
Pentousis, D, Cooper, JP, Cobbe, SM. Prolonged asystole induced by head up tilt test. Report of four cases and brief review of the prognostic significance and medical management. Heart 1997; 77: 273–275.CrossRefGoogle ScholarPubMed
Sanatani, S, Chau, V, Fournier, A, et al. Canadian cardiovascular society and Canadian pediatric cardiology association position statement on the approach to syncope in the pediatric patient. Can J Cardiol 2017; 33: 189–198.CrossRefGoogle Scholar
Maggi, R, Solari, D, Brignole, M. What’s new in the 2018 ESC guidelines for the diagnosis and management of syncope? G Ital Cardiol (Rome) 2018; 19: 668–671.Google ScholarPubMed
Tao, C, Xu, B, Liao, Y, Li, X, Jin, H, Du, J. Predictor of syncopal recurrence in children with vasovagal syncope treated with metoprolol. Front Pediatr 2022; 10: 870939.CrossRefGoogle ScholarPubMed
Tao, C, Chen, S, Li, X, Tang, C, Du, J, Jin, H. Body mass index is a promising predictor of response to oral rehydration saline in children with vasovagal syncope. Chin Med J 2021; 134: 463–468.CrossRefGoogle Scholar
Armour, JA. Functional anatomy of intrathoracic neurons innervating the atria and ventricles. Heart rhythm 2010; 7: 994–996.CrossRefGoogle ScholarPubMed
Chiou, CW, Eble, JN, Zipes, DP. Efferent vagal innervation of the canine atria and sinus and atrioventricular nodes. Circulation 1997; 95: 2573–2584.CrossRefGoogle ScholarPubMed
Lu, Y, Wei, Wei, Upadhyay, GA, Tung, R. Catheter-based cardio-neural ablation for refractory vasovagal syncope: first U.S. JACC Case Rep 2020; 2: 1161–1165.CrossRefGoogle ScholarPubMed
Tu, B, Wu, L, Hu, F, et al. Cardiac deceleration capacity as an indicator for cardioneuroablation in patients with refractory vasovagal syncope. Heart Rhythm 2022; 19: 562–569.CrossRefGoogle ScholarPubMed
Chinese Medicine Subspecialty of Cardiovascular Study Group. Children syncope diagnostic guidelines, 2016; 54: 246–250.Google Scholar
Yao, Y, Ding, L, Chen, W, et al. The training and learning process of transseptal puncture using a modified technique. Europace 2013; 15: 1784–1790.CrossRefGoogle ScholarPubMed
Yang, J, Li, H, Ochs, T, et al. Erythrocytic hydrogen sulfide production is increased in children with vasovagal syncope. J Pediatr 2015; 166: 965–969.CrossRefGoogle ScholarPubMed
Ali, M, Pachon Maetos, JC, Kichloo, A, et al. Management strategies for vasovagal syncope. Pacing Clin Electrophysiol 2021; 44: 2100–2108.CrossRefGoogle ScholarPubMed
Paech, C, Wagner, F, Mensch, S, et al. Cardiac pacing in cardioinhibitory syncope in children. Congenit Heart Dis 2018; 13: 1064–1068.CrossRefGoogle ScholarPubMed
Zheng, L, Sun, W, Qiao, Y, et al. Symptomatic premature ventricular contractions in vasovagal syncope patients: autonomic modulation and catheter ablation. Front Physiol 2021; 3: 653225.CrossRefGoogle Scholar
Xu, L, Zhao, Y, Duan, Y, et al. Clinical efficacy of catheter ablation in the treatment of vasovagal syncope. J Clin Med 2022; 11: 5371.CrossRefGoogle ScholarPubMed
Pachon, JC, Pachon, EI, Cunha Pachon, MZ, et al. Catheter ablation of severe neurally meditated reflex (neurocardiogenic or vasovagal) syncope: cardioneuroablation long-term results. Europace 2011; 13: 1231–1242.CrossRefGoogle ScholarPubMed
Liang, Z, Jiayou, Z, Zonggui, W, Dening, L. Selective atrial vagal denervation guided by evoked vagal reflex to treat refractory vasovagal syncope. Pacing Clin Electrophysiol 2012; 35: e214–e218.CrossRefGoogle ScholarPubMed