Effectiveness of cardioneuroablation in different subtypes of vasovagal syncope  

作　　者：Bin TU Zi-Hao LAI Ai-Yue CHEN Zhi-Yuan WENG Si-Min CAI Zhu-Xin ZHANG Li-Kun ZHOU Li-Hui ZHENG Yan YAO 

机构地区：[1]Arrhythmia Center,Fuwai Hospital,National Center for Cardiovascular Diseases,National Key Laboratory,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China [2]Cardiac Center,Beijing Chaoyang Hospital,Capital Medical University,Beijing,China [3]Cardiovascular Department,The First Affiliated Hospital,Fujian Medical University,Fujian Institute of Hypertension,Fujian,China [4]Department of Cardiovascular,The Second Affiliated Hospital of Zhejiang University School of Medicine,Zhejiang,China

出　　处：《Journal of Geriatric Cardiology》2024年第6期651-657,共7页老年心脏病学杂志（英文版）

基　　金：supported by the CAMS Central Public Welfare Scientific Research Institute Basal Research Expenses (No.2021-XCGC09-1&No.2022-I2M-C&T-B-045);the Beijing Municipal Science&Technology Commission (Z191100006619019);the High-level Hospital Clinical Scientific Research Business Fees (No.2022-GSP-QZ-4)

摘　　要：BACKGROUND Cardioneuroablation(CNA)has shown encouraging results in patients with vasovagal syncope(VVS).However,data on different subtypes was scarce.METHODS This observational study retrospectively enrolled 141 patients[mean age:40±18 years,51 males(36.2%)]with the diagnosis of VVS.The characteristics among different types of VVS and the outcomes after CNA were analyzed.RESULTS After a mean follow-up of 4.3±1.5 years,41 patients(29.1%)experienced syncope/pre-syncope events after CNA.Syncope/pre-syncope recurrence significantly differed in each subtype(P=0.04).The cardioinhibitory type of VVS had the lowest recurrence rate after the procedure(n=6,16.7%),followed by mixed(n=26,30.6%)and vasodepressive(n=9,45.0%).Additionally,a significant difference was observed in the analyses of the Kaplan-Meier survival curve(P=0.02).Syncope/pre-syncope burden was significantly reduced after CNA in the vasodepressive type(P<0.01).Vasodepressive types with recurrent syncope/pre-syncope after CNA have a lower baseline deceleration capacity(DC)level than those without(7.4±1.0 ms vs.9.0±1.6 ms,P=0.01).Patients with DC<8.4 ms had an 8.1(HR=8.1,95%CI:2.2-30.0,P=0.02)times risk of syncope/pre-syncope recurrence after CNA compared to patients with DC≥8.4 ms,and this association still existed after adjusting for age and sex(HR=8.1,95%CI:2.2-30.1,P=0.02).CONCLUSIONS Different subtypes exhibit different event-free rates.The vasodepressive type exhibited the lowest event-free rate,but those patients with DC≥8.4 ms might benefit from CNA.

关 键 词：SYNCOPE SUBTYPES DIAGNOSIS 

分 类 号：R54[医药卫生—心血管疾病]