Cardioneuroablation as a method of therapy in vasovagal syncope

Vasovagal syncope is the most common cause of transient loss of consciousness, may significantly impair quality of life and lead to injury. Current treatment of vasovagal syncope is based on patient education, lifestyle modification, pharmacotherapy and, in extreme cases, implantation of a pacemaker. In recent years, more and more data on cardioneuroablation have been published – a new treatment method for neurally mediated asystolic syncope. This article summarizes the current state of knowledge about this method, presents indications for this procedure and shows perspectives for its development.

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Lifestyle Modification as a Method of Treatment of Vasovagal Syncope

Kardiologiia ◽

10.18087/cardio.2020.1.n776 ◽

2020 ◽

Vol 60 (1) ◽

pp. 93-98

Author(s):

E. A. Kuchinskaya ◽

A. V. Pevzner

Keyword(s):

Lifestyle Modification ◽

Vasovagal Syncope ◽

Loss Of Consciousness ◽

Common Cause ◽

Need For Treatment ◽

Vasovagal Reaction ◽

Effective Use ◽

Time Information ◽

Impaired Quality

Vasovagal syncope is the most common cause for loss of consciousness. The need for treatment of this condition is warranted by impaired quality of life and a risk of trauma due to the fall. At present, there are no medications with proven preventive effectiveness for vasovagal syncope as demonstrated by large randomized, placebo-controlled studies. At the same time, information about the pathogenesis of vasovagal reaction and provoking factors allows effective use of non-drug methods (such as patient education, physical exercise, maneuvers) in the management of patients with vasovagal syncope.

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What's the Buzz? The Neuroscience and the Treatment of Tinnitus

Physiological Reviews ◽

10.1152/physrev.00029.2020 ◽

2021 ◽

Author(s):

Amanda Henton ◽

Thanos Tzounopoulos

Keyword(s):

United States ◽

The United States ◽

Global Scale ◽

Current Treatment ◽

Public Health Issue ◽

Current State ◽

Acquired Hearing Loss ◽

Neurophysiological Mechanisms ◽

Necessary And Sufficient

Tinnitus is a pervasive public health issue that affects approximately 15% of the United States population. Similar estimates have also been shown on a global scale, with similar prevalence found in Europe, Asia, and Africa. The severity of tinnitus is heterogeneous, ranging from mildly bothersome to extremely disruptive. In the United States, approximately 10-20% of individuals who experience tinnitus report symptoms that severely reduce their quality of life. Due to the huge personal and societal burden, in the last twenty years a concerted effort on basic and clinical research has significantly advanced our understanding and treatment of this disorder. Yet, neither full understanding, nor cure exists. We know that tinnitus is the persistent involuntary phantom percept of internally-generated non-verbal noises and tones, which in most cases is initiated, by acquired hearing loss and maintained only when this loss is coupled with distinct neuronal changes in auditory and extra-auditory brain networks. Yet, the exact mechanisms and patterns of neural activity that are necessary and sufficient for the perceptual generation and maintenance of tinnitus remain incompletely understood. Combinations of animal model and human research will be essential in filling these gaps. Nevertheless, the existing progress in investigating the neurophysiological mechanisms has improved current treatment and highlighted novel targets for drug development and clinical trials. The aim of this review is to thoroughly discuss the current state of human and animal tinnitus research, outline current challenges, and highlight new and exciting research opportunities.

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Implantation and Retrieval of Magnetic Nanobots for Treatment of Endodontic Re-Infection in Human Dentine

10.26434/chemrxiv.14494914 ◽

2021 ◽

Author(s):

Debayan Dasgupta ◽

Shanmukh Srinivas Peddi ◽

Deepak K. Saini ◽

Ambarish Ghosh

Keyword(s):

Root Canal ◽

Treatment Method ◽

Therapeutic Modality ◽

Clinical Practices ◽

Human Teeth ◽

Dentinal Tubules ◽

Current State ◽

Human Dentine ◽

New Treatment ◽

Magnetic Drive

<div> <div> <div> <p>More than 10% of root canal treatments undergo failure worldwide due to remnant bacteria deep in the dentinal tubules located within the dentine tissue of human teeth. Owing to the complex and narrow geometry of the tubules, current techniques relying on passive diffusion of anti-bacterial agents are inadequate. Here, we present a new treatment method using actively maneuvered nanobots, which can be incorporated during standard root canal procedure. Our technique will enable dentists to execute procedures inside the dentine not yet possible by current state of the art. We demonstrate that magnetically driven nanobots can reach the depths of the tubules up to hundred times faster than current clinical practices. Subtle modifications of the magnetic drive allowed deep implantation of the nanobots isotopically distributed throughout the dentine, along with spatially controlled retrieval from selected areas. Finally, we demonstrate the integration of bactericidal therapeutic modality with the nanobots, thereby validating the tremendous potential of nanobots in dentistry, and nanomedicine in general. </p> </div> </div> </div>

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Cardioneuroablation: Catheter Vagal Denervation as a New Therapy for Cardioinhibitory Syncope

Journal of Cardiac Arrhythmias ◽

10.24207/jca.v32n3.067_in ◽

2020 ◽

Vol 32 (3) ◽

pp. 182-196

Author(s):

José Carlos Pachon Mateos ◽

Enrique I Pachón Mateos ◽

Christian Higuti ◽

Tomas Guilhermo Santillana Peña ◽

Tasso Julio Lobo ◽

...

Keyword(s):

Heart Disease ◽

Preventive Measures ◽

Therapeutic Option ◽

Vasovagal Syncope ◽

Pacemaker Implantation ◽

Young Patients ◽

Loss Of Consciousness ◽

Spectral Mapping ◽

Transient Loss ◽

Vagal Reflex

The vasovagal syncope is the most frequent cause of transient loss of consciousness, especially in young people without significant heart disease. The malignant cardioinhibitory form is caused by abrupt and intense vagal reflex with or without defined triggers. Refractory cases to preventive measures and pharmacological handling has been treated with definitive pacemaker implantation. Besides showing questionable results, pacemaker implantation is highly rejected by young patients. In the late 1990s, we proposed specific vagal denervation by catheter ablation and spectral mapping, for paroxysmal AF, functional bradyarrhythmias and severe cases of malignant cardioinhibitory syncope giving rise to cardioneuroablation. Recently, many authors worldwide have been reproducing the cardioneuroablation results where elimination or significant reduction of the vagal response were observed, which abolished symptoms in more than 75% of patients followed up to 14 years, without complications. Therefore, cardioneuroablation has shown to be a real therapeutic option in malignant syncope cardioinhibitory and in any exclusive vagal mediated bradyarrhythmia without the need for pacemaker implantation.

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An Alternative to Current Therapies of Functional Dyspepsia: Self-Administrated Transcutaneous Electroacupuncture Improves Dyspeptic Symptoms

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2014/832523 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 26

Author(s):

Ting Ji ◽

Xueliang Li ◽

Lin Lin ◽

Liuqin Jiang ◽

Meifeng Wang ◽

...

Keyword(s):

Quality Of Life ◽

Gastric Emptying ◽

Functional Dyspepsia ◽

Therapeutic Potential ◽

Treatment Options ◽

Treatment Method ◽

Gastric Accommodation ◽

Dyspeptic Symptoms ◽

New Treatment

Functional dyspepsia is of high prevalence with little treatment options. The aim of this study was to develop a new treatment method using self-management transcutaneous electroacupuncture (TEA) for functional dyspepsia (FD). Twenty-eight patients with FD were enrolled and underwent a crossover clinical trial with 2-week TEA at ST36 and PC6 and 2-week sham-TEA at nonacupuncture sham-points. Questionnaires were used to assess symptoms of dyspepsia and quality of life. Physiological testing included gastric emptying and electrogastrography. It was found that (1) TEA but not sham-TEA significantly improved dyspeptic symptoms and 4 domains in quality of life; improvement was also noted in self-rated anxiety and depression scores; (2) gastric emptying was significantly and substantially increased with 2-week TEA but not sham-TEA; and (3) gastric accommodation was also improved with TEA but not sham-TEA, reflected as increased ingested nutrient volumes at the levels of satiety and maximum tolerance. These findings suggest a therapeutic potential of self-administrated TEA method for functional dyspepsia, possibly attributed to improvement in gastric motility.

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NEW TREATMENT OPTION FOR ESOPHAGOGASTRIC ANASTOMOTIC LEAK: A CASE REPORT

Siberian Journal of Oncology ◽

10.21294/1814-4861-2019-18-4-102-105 ◽

2019 ◽

Vol 18 (4) ◽

pp. 102-105

Author(s):

M. M. Davydov ◽

A. G. Abdullaev ◽

O. A. Malikhova ◽

A. V. Tsigankova

Keyword(s):

Anastomotic Leak ◽

Treatment Option ◽

Treatment Method ◽

Esophageal Resection ◽

Thoracic Esophagus ◽

Invasive Treatment ◽

Urgent Surgery ◽

New Treatment ◽

Surgical Clinic

The formation of esophagogastric anastomosis has a long history due to the search for the most reliable and safe fistula. The use of invagination anastomosis, proposed in the early 90s by Professor M.I. Davydov, fully met all the requirements, allowing significantly improve the quality of life of patients and significantly reducing the frequency of failure of the anastomoses to 0.5%.Case description. We present the case of proximal gastric cancer invading the lower thoracic esophagus. The patient underwent proximal subtotal gastric and lower thoracic esophageal resection using the combination of a laparotomy and right thoracotomy. Contrast radiography performed on day 11 after surgery revealed esophagogastric anastomotic leak. The patient underwent urgent surgery.Conclusion. This article presents a new treatment option for esophagogastric anastomotic leak by using endoscopic transesophageal clipping of the defect in combination with sanitation and drainage of the pleural/mediastinsl cavity. The proposed technique can be considered as a minimally invasive treatment method and can be used in any surgical clinic.

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Sex and age impact prevalence and symptoms of vasovagal syncope: Implications for accurate diagnosis

STEM Fellowship Journal ◽

10.17975/sfj-2021-008 ◽

2021 ◽

pp. 1-3

Author(s):

Hailey Gregson ◽

Ana Ivkov

Keyword(s):

Blood Flow ◽

Spontaneous Recovery ◽

Vasovagal Syncope ◽

Common Type ◽

Accurate Diagnosis ◽

Loss Of Consciousness ◽

Transient Loss Of Consciousness ◽

Transient Loss ◽

Autonomic Reflex ◽

The Brain

Syncope is characterized by the transient loss of consciousness followed by spontaneous recovery. The mechanism which underlies this condition is reduced blood flow to the brain [1]. Vasovagal syncope, often termed reflex syncope, is the most common type of syncope [1]. Vasovagal Syncope is caused by the abnormal autonomic reflex to certain stimuli such as pain, micturition/defecation, fear, seeing blood, etc., which results in vasodilation and often times, bradycardia [1].

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