| Title |
Simplified Method for Vagal Effect Evaluation in Cardiac Ablation and Electrophysiological Procedures
|
|---|---|
| Published in |
JACC: Clinical Electrophysiology, August 2015
|
| DOI | 10.1016/j.jacep.2015.06.008 |
| Pubmed ID | |
| Authors |
Jose C. Pachon M., Enrique I. Pachon M., Tomas G. Santillana P., Tasso J. Lobo, Carlos T.C. Pachon, Juan C. Pachon M., Remy N. Albornoz V., Juan 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) through the internal jugular vein pre- and post-ablation. Significant cardioinhibition was achieved pre-ablation in all cases (pause of 11.5 ± 1.9 s in DG vs. 11.4 ± 2.1 s in CG; p = 0.79). Eight patients (12.5%) presented catheter progression difficulty in 1 jugular vein (2 right, 6 left); however, the contralateral VS was adequate for cardioinhibition. After ablation, the cardioinhibition was reproduced only in CG (pause of 11.2 ± 2.2 s) as in DG it was entirely eliminated. There was no significant difference between pre- and post-ablation cardioinhibition in CG (p = 0.84). There was no complication (follow-up 8.8 ± 5 months). The vagal stimulation was feasible, easy, and reliable, and showed no complications. It may be repeated during the procedure to control the denervation degree without residual effect. It could be a suitable tool for vagal denervation confirmation or autonomic tests during electrophysiological studies. Ablation without parasympathetic denervation did not change the vagal response. |
X Demographics
The data shown below were collected from the profiles of 6 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Brazil | 2 | 33% |
| United States | 1 | 17% |
| Turkey | 1 | 17% |
| India | 1 | 17% |
| Unknown | 1 | 17% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 4 | 67% |
| Scientists | 1 | 17% |
| Science communicators (journalists, bloggers, editors) | 1 | 17% |
Mendeley readers
The data shown below were compiled from readership statistics for 54 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 54 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 10 | 19% |
| Researcher | 6 | 11% |
| Student > Ph. D. Student | 5 | 9% |
| Student > Doctoral Student | 4 | 7% |
| Student > Postgraduate | 4 | 7% |
| Other | 6 | 11% |
| Unknown | 19 | 35% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 28 | 52% |
| Engineering | 2 | 4% |
| Agricultural and Biological Sciences | 1 | 2% |
| Economics, Econometrics and Finance | 1 | 2% |
| Nursing and Health Professions | 1 | 2% |
| Other | 0 | 0% |
| Unknown | 21 | 39% |
Attention Score in Context
This research output has an Altmetric Attention Score of 16. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 November 2022.
All research outputs
#2,262,508
of 25,420,980 outputs
Outputs from JACC: Clinical Electrophysiology
#537
of 1,556 outputs
Outputs of similar age
#29,001
of 277,745 outputs
Outputs of similar age from JACC: Clinical Electrophysiology
#2
of 10 outputs
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