Why the study?
Does endocardial catheter ablation of the superior vena cava-aorta ganglionated plexus prevent syncope in a patient with cardioinhibitory neurally mediated syncope and dextrocardia?
Does endocardial catheter ablation of the superior vena cava-aorta ganglionated plexus prevent syncope in a patient with cardioinhibitory neurally mediated syncope and dextrocardia?
Catheter ablation of the superior vena cava-aorta ganglionated plexus successfully prevented syncope and improved heart rate in a young patient with refractory cardioinhibitory neurally mediated syncope and dextrocardia.
Single-case success suggests possible benefit in refractory cardioinhibitory syncope with dextrocardia; prospective trials needed before broader adoption.
Neurally mediated reflex syncope is the most common cause of syncope in young individuals without cardiac or neurological pathology. We report a case of successful catheter ablation in a 17-year-old male with neurally mediated syncope (NMS) of the cardioinhibitory type. The patient had dextrocardia situs inversus totalis with a mirror-image reversal of the thoracic and abdominal organs. Because he experienced multiple syncope episodes despite pharmacological intervention, we performed endocardial ablation of the superior vena cava-aorta ganglionated plexus. Shortly afterwards, his heart rate increased from 40 to 76 beats per minutes. He has not experienced syncope during the 1-year follow-up.
No takes yet. Share an insight, caveat, or question.
Suenaga et al. (2014) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: