医学
血管迷走性晕厥
心动过缓
病理生理学
心脏病学
内科学
窦性心动过缓
心率变异性
心率
不利影响
自主神经系统
平衡(能力)
麻醉
晕厥(音系)
血压
物理医学与康复
作者
Praloy Chakraborty,Peng‐Sheng Chen,Michael H. Gollob,Brian Olshansky,Sunny S. Po
标识
DOI:10.1016/j.hrthm.2023.12.004
摘要
Cardioneuroablation (CNA) is being increasingly used to treat patients with vasovagal syncope (VVS). Bradycardia, in the cardioinhibitory subtype of VVS, results from transient parasympathetic overactivity leading to sinus bradycardia and/or AV block. By mitigating parasympathetic overactivity, CNA has been shown to improve VVS symptoms in clinical studies with relatively small sample sizes and short follow-ups (<5 years) at selected centers. However, CNA may potentially tip the autonomic balance to a state of sympathovagal imbalance with attenuation of cardiac parasympathetic activity. A higher heart rate is associated with adverse cardiovascular events and increased mortality in healthy populations without cardiovascular diseases. Chronic sympathovagal imbalance may also affect the pathophysiology of spectra of cardiovascular disorders including atrial and ventricular arrhythmias. This review addresses potential long-term pathophysiological consequences of CNA for VVS
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