Abstract：
Cardioneuroablation (CNA) is being increasingly used to treat patients with vasovagal syncope (VVS). Bradycardia, in the cardioinhibitory subtype of VVS, results from transient parasympathetic overactivity leading to sinus bradycardia and/or atrioventricular block. By mitigating parasympathetic overactivity, CNA has been shown to improve VVS symptoms in clinical studies with relatively small sample sizes and short follow-up periods (<5 years) at selected centers. However, CNA may potentially tip the autonomic balance to a state of sympathovagal imbalance with attenuation of cardiac parasympathetic activity. A higher heart rate is associated with adverse cardiovascular events and increased mortality in healthy populations without cardiovascular diseases. Chronic sympathovagal imbalance may also affect the pathophysiology of spectra of cardiovascular disorders including atrial and ventricular arrhythmias. This review addresses potential long-term pathophysiological consequences of CNA for VVS.
摘要：
心脏神经消融（CNA）越来越多地用于治疗血管迷走性晕厥（VVS）患者。心动过缓,在VVS的心脏抑制亚型中，短暂性副交感神经过度活动导致窦性心动过缓和/或房室传导阻滞。通过减轻副交感神经过度活动，在临床研究中，CNA已被证明可以改善VVS症状，样本量相对较小，随访时间较短（<5年）。然而,CNA可能会使自主神经平衡倾向于交感迷走神经失衡状态，并减弱心脏副交感神经活动。在没有心血管疾病的健康人群中，较高的心率与不良心血管事件和死亡率增加有关。慢性交感迷走神经失衡也可能影响包括心房和室性心律失常在内的心血管疾病频谱的病理生理学。这篇综述讨论了CNA对VVS的潜在长期病理生理后果。
