Simplified Method for Vagal Effect Evaluation in Cardiac Ablation and Electrophysiological Procedures

JACC. Clinical Electrophysiology
Jose C Pachon MJuan C Zerpa A

Abstract

The aim of this study is to show a simplified reversible approach to investigate and confirm vagal denervation at any time during the ablation procedure without autonomic residual effect. Parasympathetic denervation has been increasingly applied in ablation procedures such as in vagal-related atrial fibrillation and cardioneuroablation. This method proposes an easy way to study the vagal effect and to confirm its elimination following parasympathetic denervation through vagal stimulation (VS) by an electrophysiological catheter placed in the internal jugular vein. A prospective controlled study including 64 patients without significant cardiopathy (48 male [75.0%], age 46.4 ± 16.4 years) who had a well-defined RF ablation indication for symptomatic arrhythmias, comprising a "denervation group" (DG), with indication for ablation with parasympathetic denervation (vagal-related atrial fibrillation or severe cardioinhibitory syncope) and a "control group" (CG), with ablation indication without parasympathetic denervation (accessory pathway or ventricular arrhythmia). By using a neurostimulator, both groups underwent non simultaneous bilateral VS (8 to 12 s, frequency: 30 Hz, pulse width: 50 μs, amplitude: 0.5 to 1 V/kg up to 70 V) ...Continue Reading

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Jul 15, 2017·Circulation. Arrhythmia and Electrophysiology·Esteban W Rivarola, Mauricio Scanavacca
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Nov 9, 2021·Pacing and Clinical Electrophysiology : PACE·Muzaffar AliKhalil Kanjwal

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