Anatomic ablation of left superior and right anterior ganglion plexuses reduced syncope incidence to 6.3% vs 34.4% and prodromal symptoms to 12.5% vs 53.1%.
Does anatomic ablation of the left superior and right anterior ganglion plexuses reduce syncope and prodromal symptoms in patients with vasovagal syncope?
Anatomic ablation of the left superior and right anterior ganglion plexuses significantly reduces the incidence of syncope and prodromal symptoms in patients with vasovagal syncope compared to routine treatment alone.
Absolute Event Rate: 0% vs 0%
Abstract Background Vasovagal syncope is the most common cause of syncope across all age groups. Previous studies have demonstrated that targeted ablation modification of specific ganglionated plexi can attenuate vagally mediated cardiac inhibition, thereby reducing syncope episodes. However, catheter ablation strategies vary among different centers. Seeking a simplified yet effective ablation approach will facilitate the application of catheter ablation in the treatment of vasovagal syncope. Purpose To evaluate the effectiveness and safety of anatomic ablation of the left superior ganglion plexus and right anterior ganglion plexus in the treatment of vasovagal syncope. Methods Patients with vasovagal syncope who tested positive on Head-up Tilt Testing were enrolled and divided into an ablation group and a control group. Patients in the ablation group underwent anatomic catheter ablation of the left superior ganglion plexus (LSGP) and right anterior ganglion plexus (RAGP) in addition to routine treatment, while patients in the control group received guideline-directed routine treatment. The primary endpoint was the occurrence of syncope and prodromal symptoms within 12 months. Results According to the inclusion and exclusion criteria, sixty-four patients were enrolled for analysis using propensity score matching with thirty-two in each group (ablation and non-ablationl) in the retrospective case-control study. The mean follow-up duration was 16.2±6.4 months. During the follow-up, 20.3% (13/64) of patients experienced syncope, and 32.8% (21/64) had prodromal symptoms. The incidence of syncope was lower in the ablation group compared to the control group (6.3% vs 34.4%, P=0.005). The incidence of prodromal symptoms was also lower in the ablation group compared to the control group (12.5% vs 53.1%, P0.001). The number of syncope events was lower in the ablation group than in the control group (4/32 vs 22/32, P=0.021), and the number of prodromal symptoms was also lower in the ablation group (7/32 vs 29/32, P=0.001). Only one patient in the ablation group developed a hematoma at the puncture site, and no other complications were observed. Conclusion Anatomic ablation of the left superior ganglion plexus and right anterior ganglion plexus can reduce the occurrence of vasovagal syncope with high safety.A patient's ablation case 12 months follow-up results
Xu et al. (Sat,) reported a other. Anatomic ablation of left superior and right anterior ganglion plexuses reduced syncope incidence to 6.3% vs 34.4% and prodromal symptoms to 12.5% vs 53.1%.