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Europace 2005 7(1):1-13; doi:10.1016/j.eupc.2004.10.003
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© 2005 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved.

"Cardioneuroablation" – new treatment for neurocardiogenic syncope, functional AV block and sinus dysfunction using catheter RF-ablation

Jose C. Pachon M*, Enrique I. Pachon M, Juan C. Pachon M, Tasso J. Lobo, Maria Z. Pachon, Remy N.A. Vargas and Adib D. Jatene

Sao Paulo Heart Hospital and Dante Pazzanese Cardiology Institute, Pacemaker and Arrhythmias Acoce, 515/31 Indianopolis, 04075023 Sao Paulo, SP, Brazil

Cardiac neuroablation is a new technique for management of patients with dominantly adverse parasympathetic autonomic influence. The technique is based on radiofrequency (RF) ablation of autonomic connections in the three main ganglia around the heart. Their connections are identified by Fast-Fourier Transforms (FFTs) of endocardial signals: sites of autonomic nervous connections show fractionated signals with FFTs shifted to the right. In contrast, normal myocardium without these connections does not show these features. RF-ablation is thought to inflict permanent damage on the parasympathetic autonomic influence because its cells are adjacent to the heart whereas sympathetic cells are remote. Twenty-one patients with a mean age of 48 years, neurally mediated reflex syncope in six, functional high grade atrioventricular block in seven and sinus node dysfunction in 13 (there is overlap between the second and third groups) were treated. Follow-up for a mean of 9.2 months demonstrated success in all cases with relief of symptoms. No complications occurred.

Key Words: sinus node dysfunction, RF catheter ablation, neurocardiogenic syncope, functional atrioventricular block

*Corresponding author. Tel./fax: +55 11 50514646. E-mail address: jcpachon{at}hotmail.com (J.C. Pachon M).


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