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dc.contributor.authorGuler, Tumer Erdem
dc.contributor.authorYalin, Kivanc
dc.contributor.authorBozyel, Serdar
dc.contributor.authorAksu, Tolga
dc.date.accessioned2021-03-02T18:33:40Z
dc.date.available2021-03-02T18:33:40Z
dc.identifier.citationAksu T., Guler T. E. , Bozyel S., Yalin K., "Selective vagal innervation principles of ganglionated plexi: step-by-step cardioneuroablation in a patient with vasovagal syncope", JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY, 2020
dc.identifier.issn1383-875X
dc.identifier.othervv_1032021
dc.identifier.otherav_004379e6-fae5-41f2-9990-6c7a26235d26
dc.identifier.urihttp://hdl.handle.net/20.500.12627/5144
dc.identifier.urihttps://doi.org/10.1007/s10840-020-00757-3
dc.description.abstractCardioneuroablation (CNA) is an endocardial ablation technique aiming to prevent the autonomic imbalance occurring in vasovagal syncope (VVS). A 46-year-old female was referred to our center for pacemaker implantation due to recurrent syncopal episodes despite conventional treatments. A 22-s asystole was detected on head-up tilt testing. After a discussion with the patient and her family, we decided to perform CNA. Positive response was confirmed, and procedural endpoints were defined using pre-procedural atropine response test. Ganglionated plexus (GP) sites were detected and ablated by using fractionated electrogram (FE)-based strategy. During baseline electrophysiological study, AA and PR intervals were calculated as 810 ms and 164 ms, respectively. Based on our ablation order, radiofrequency ablation (RFA) was started from the left inferior and left superior GPs, respectively. A significant vagal response with sinus pauses and atrioventricular (AV) block was detected during RFA. Ablation of the right superior GP caused a significant increase of sinus rate with continuing AV block. After completion of ablation on the right superior and inferior GPs, PR interval was still 164 ms although AA interval decreased to 640 ms. After RFA on the posteromedial left GP which provides mainly vagal innervation of AV node, PR interval and cycle length of sinus node were detected as 134 ms and 540 ms, respectively. Selective parasympathetic innervation principles of the sinus node and AV node were previously demonstrated. We described a case of successful parasympathetic denervation of the sinus node and AV nodes using CNA.
dc.language.isoeng
dc.subjectDahili Tıp Bilimleri
dc.subjectKardiyoloji
dc.subjectSağlık Bilimleri
dc.subjectTıp
dc.subjectKlinik Tıp (MED)
dc.subjectKlinik Tıp
dc.subjectCARDIAC ve CARDIOVASCULAR SİSTEMLER
dc.titleSelective vagal innervation principles of ganglionated plexi: step-by-step cardioneuroablation in a patient with vasovagal syncope
dc.typeMakale
dc.relation.journalJOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY
dc.contributor.departmentKocaeli Derince Training & Research Hospital , ,
dc.contributor.firstauthorID2281102


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