Clinical analysis of cardiac autonomic ganglion plexus ablation for bradyarrhythmia: Research protocol for an intervention study
Clinical analysis of cardiac autonomic ganglion plexus ablation for bradyarrhythmia: Research protocol for an intervention study
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心脏自主神经节丛消融术治疗缓慢性心律失常的临床分析：干预研究方案
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
汤宝鹏
中科院分区：
文献类型：
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作者：
邵明亮;李耀东;周贤惠;卢颜美;张玲;汤宝鹏
目的：本研究旨在探讨选择性心脏自主神经节丛（GP）消融治疗缓慢性心律失常的安全性和有效性。心脏由其自身的内在和中枢自主神经控制。心脏迷走神经张力增加导致窦房结功能障碍和房室传导障碍，从而导致缓慢性心律失常。植入起搏器可以缓解心动过缓引起的心律失常的症状，但患者不易接受植入起搏器作为一种治疗形式。因此，心脏迷走神经消融术越来越受到重视。研究方法：本研究纳入了2019年11月至2020年6月在新疆医科大学第一附属医院行GP消融术的符合入选标准的患者20例。消融前进行沿着电生理检查及生化等相关检查，然后进行心脏GP消融。术后3、6、12个月随访3次。结果：心脏自主神经GP消融治疗后，最小心率和平均心率明显增加（P<0.01）。心脏自主神经节丛消融治疗6个月和12个月后，SDNN（正常-正常间期标准差）和RMSSD（连续R-R间期间的均方根连续差）显著降低（p<0.01）。结论：心脏GP消融术相对简单，易于在已对缓慢性心律失常进行射频消融的单位中实施。该过程可以在没有任何新设备的情况下进行。有些心动过缓患者可能没有永久性起搏器植入，可能需要额外的治疗选择。关键词：缓慢性心律失常，心脏神经节丛，消融
Objective: This study aimed to explore the safety and effectiveness of selective cardiac autonomic ganglion plexus (GP) ablation on patients .with bradyarrhythmia. The heart is controlled by its own intrinsic and central autonomic nerves. Increased cardiac vagal tone leads to sinus .node dysfunction and atrioventricular conduction disorders, resulting in bradyarrhythmia. Pacemaker implantation can relieve the symptoms .of arrhythmia caused by bradycardia, but it is not easy for patients to accept a pacemaker implantation as a form of treatment. Therefore, more .and more attention has been paid to cardiac vagus nerve ablation..Methods: In this study, 20 patients who met the inclusion criteria of GP ablation in the First Affiliated Hospital of Xinjiang Medical University from .November 2019 to June 2020 were enrolled. Biochemical and other related examinations along with electrophysiological examinations were conducted before ablation, and then cardiac GP ablation was performed. The patients were followed up 3 times at 3, 6, and 12 months after the operation..Results: The minimum HR and mean HR were significantly increased after treatment with cardiac autonomic GP ablation (p<0.01). Moreover, .the SDNN (Standard deviation of Normal-to-Normal Intervals) and RMSSD (Root mean square successive differences between successive .R-R intervals) was significantly decreased after treatment with cardiac autonomic ganglion plexus ablation for 6 months and 12 months (p<0.01)..Conclusion: Cardiac GP ablation is relatively simple and easy to implement in units that have performed radiofrequency ablation for bradyarrhythmias. This procedure can be performed without any new equipment. Some patients with bradycardia may not have a permanent pacemaker implantation and may go in for additional treatment options..Keywords: bradyarrhythmia, cardiac ganglionated plexus, ablation