Arrhythmias & electrophysiology
Long-Term Outcome of Cardiac Denervation Procedures: The Anatomically Guided Septal Approach
Authors' conclusion
The anatomically guided septal approach is an effective technique for syncope prevention, promoting long-lasting autonomic changes. No significant proarrhythmia effect has been observed during the long-term follow-up.
Study context
- Population
- Patients with symptomatic functional bradycardia
- Participants
- 36 patients
- Outcome
- Freedom from events
- Follow-up
- Mean 52.1 ± 35.2 months
Main finding
As reported in the abstract
Patients free of events
30
83.3%
Observational data: associations, not effects.
Further findings
Syncope recurrence during follow-up
- Syncope recurrence
- 4 (11.1%)
- Requiring pacemaker implantation
- 3 (8.3%)
Sinus node denervation
- Obtained in all patients; increment in mean heart rate
- 21.6%
- Negative atropine test after ablation
- all patients
Atrioventricular node denervation (immediate signs)
- Patients with immediate signs
- 28 (77.7%)
- Shortening of mean Wenckebach cycle length
- 15.6%
- Shortening of mean atrio-Hisian (AH) interval
- 15.9%
Heart rate variability parameters · 12 months
- All parameters significantly reduced after 12 months, enduring after 18 months
Safety
Complications and proarrhythmia
- Acute sinus node artery occlusion during ablation with persistent sinus dysfunction and pacemaker implantation
- 1 (2.77%)
- Sinus tachycardia
- 3 (8.3%)
- No other tachyarrhythmia observed
Original publication
Long-Term Outcome of Cardiac Denervation Procedures: The Anatomically Guided Septal Approach. JACC Clin Electrophysiol. Published 22 March 2023. doi:10.
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