Cardioneuroablation for the management of patients with recurrent vasovagal syncope and symptomatic bradyarrhythmias: the CNA-FWRD Registry.

IF 2.1 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Interventional Cardiac Electrophysiology Pub Date : 2025-03-01 Epub Date: 2024-03-18 DOI:10.1007/s10840-024-01789-9

Tolga Aksu, Roderick Tung, Tom De Potter, Timothy M Markman, Pasquale Santangeli, Jeanne du Fay de Lavallaz, Jeffrey R Winterfield, Tina Baykaner, Daniel Alyesh, Jacqueline E Joza, Rakesh Gopinathannair, Patrick Badertscher, Duc H Do, Ayman Hussein, Jose Osorio, Thomas Dewland, Alexander Perino, Albert J Rodgers, Christopher DeSimone, Alberto Alfie, Brett D Atwater, David Singh, Kapil Kumar, Jonathan Salcedo, Jason S Bradfield, Gaurav Upadhyay, Nitesh Sood, Parikshit S Sharma, Sandeep Gautam, Vineet Kumar, Alexander Romeno Janner Dal Forno, Christopher E Woods, Moshe Rav-Acha, Chiara Valeriano, Sunil Kapur, Andres Enriquez, Sri Sundaram, Michael Glikson, Edward Gerstenfeld, Jonathan Piccini, Wendy S Tzou, William Sauer, Andre d'Avila, Kalyanam Shivkumar, Henry D Huang

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引用次数: 0

Abstract

Background: Cardioneuroablation has been emerging as a potential treatment alternative in appropriately selected patients with cardioinhibitory vasovagal syncope (VVS) and functional AV block (AVB). However the majority of available evidence has been derived from retrospective cohort studies performed by experienced operators.

Methods: The Cardioneuroablation for the Management of Patients with Recurrent Vasovagal Syncope and Symptomatic Bradyarrhythmias (CNA-FWRD) Registry is a multicenter prospective registry with cross-over design evaluating acute and long-term outcomes of VVS and AVB patients treated by conservative therapy and CNA.

Results: The study is a prospective observational registry with cross-over design for analysis of outcomes between a control group (i.e., behavioral and medical therapy only) and intervention group (Cardioneuroablation). Primary and secondary outcomes will only be assessed after enrollment in the registry. The follow-up period will be 3 years after enrollment.

Conclusions: There remains a lack of prospective multicentered data for long-term outcomes comparing conservative therapy to radiofrequency CNA procedures particularly for key outcomes including recurrence of syncope, AV block, durable impact of disruption of the autonomic nervous system, and long-term complications after CNA. The CNA-FWRD registry has the potential to help fill this information gap.

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治疗复发性血管迷走性晕厥和症状性缓慢性心律失常患者的心脏神经消融术：CNA-FWRD 登记。

背景：对于经过适当选择的心脏抑制性血管迷走性晕厥（VVS）和功能性房室传导阻滞（AVB）患者，心脏神经消融术已逐渐成为一种潜在的替代治疗方法。然而，现有证据大多来自经验丰富的操作者进行的回顾性队列研究：用于治疗复发性血管迷走性晕厥和症状性快速性心律失常患者的心脏血管神经消融术（CNA-FWRD）登记是一项多中心前瞻性登记，采用交叉设计，评估保守疗法和 CNA 治疗的 VVS 和 AVB 患者的急性和长期疗效：该研究是一项前瞻性观察登记，采用交叉设计，分析对照组（即仅采用行为和药物治疗）和干预组（心脏神经消融术）的疗效。主要和次要结果仅在注册登记后进行评估。随访期为注册后 3 年：目前仍缺乏前瞻性多中心数据，无法比较保守疗法与射频 CNA 手术的长期疗效，尤其是在晕厥复发、房室传导阻滞、自主神经系统破坏的持久影响以及 CNA 术后长期并发症等关键疗效方面。CNA-FWRD 登记有可能帮助填补这一信息空白。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Interventional Cardiac Electrophysiology 医学-心血管系统

CiteScore

4.30

自引率

11.10%

发文量

320

审稿时长

4-8 weeks

期刊介绍： The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.