ganglionated plexus
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2021 ◽  
Vol 34 (3) ◽  
pp. 105-112
Author(s):  
Fabricio Vassallo ◽  
Edevaldo da Silva ◽  
Lucas Luis Meigre ◽  
Christiano Cunha ◽  
Eduardo Serpa ◽  
...  

This is a series case report of five symptomatic patients presented with diagnosis of sinus bradycardia, first and second degrees atrioventricular (AV) blocks, that were referred to pacemaker implantation. During the screening, a functional cause for the bradycardia and AV blocks were documented by treadmill stress test, 24-hour Holter monitoring and atropine test. After the confirmation of the diagnosis, patients were submitted to cardioneuroablation on an anatomical basis supported by a tridimensional electroanatomical fractionation mapping software. The technique and the acute and short-term results of the cardioneuroablation are described.


Heart Rhythm ◽  
2021 ◽  
Author(s):  
Min-Young Kim ◽  
Clare Coyle ◽  
David R. Tomlinson ◽  
Markus B. Sikkel ◽  
Afzal Sohaib ◽  
...  

2021 ◽  
Vol 12 (10) ◽  
pp. 4720-4725
Author(s):  
Kivanc Yalin ◽  
Meltem Altinsoy ◽  
Ali Soysal ◽  
Tolga Aksu ◽  
Rakesh Gopinathannair ◽  
...  
Keyword(s):  

Heart Rhythm ◽  
2021 ◽  
Vol 18 (8) ◽  
pp. S93
Author(s):  
Sri Sundaram ◽  
Dan Alyesh ◽  
Benjamin Jones ◽  
Thomas Rogers ◽  
Tolga Aksu ◽  
...  

2021 ◽  
Author(s):  
Lakshmi Kuttippurathu ◽  
Alison Moss ◽  
Rajanikanth Vadigepalli

Abstract The present protocol describes transcriptome mapping, data normalization and analysis pipeline with detailed steps for each of these aspects for single cell/ low input RNASeq data from Right Atrial Ganglionated Plexus (RAGP) of pig heart. The protocol with minor modifications can be adapted for low input samples with short reads or samples with low quality input RNA. Single cell samples acquired using Laser Capture Microdissection (LCM) were processed for RNA-Seq library preparation using Smart-3SEQ technique (Foley et al 2019). The data analysis workflow consists of (a) pre-processing- data trimming, read alignment and feature count and (b) downstream analysis- annotation, batch correction, filtering and normalization. The entire protocol is performed using freely available packages. Most of them are available within the R framework.


EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
P Futyma ◽  
L Zarebski ◽  
A Wrzos ◽  
M Futyma ◽  
P Kulakowski

Abstract Funding Acknowledgements Type of funding sources: None. Background Pulmonary vein isolation (PVI) is a cornerstone for catheter ablation (CA) of atrial fibrillation (AF), however, long-term efficacy of PVI is frequently below expectations. PVI is invasive, expensive and may be associated with devastating complications. It has been postulated that vagally-mediated AF can be treated by attenuation of parasympathetic drive to the heart using cardioneuroablation by means of radiofrequency CA (RFCA) of the right anterior ganglionated plexus (RAGP), however, data in literature and guidelines are lacking. Purpose To examine the efficacy of RFCA targeting RAGP without PVI in management of vagal AF. Methods We included consecutive 9 male patients with vagal AF who underwent RFCA of RAGP without PVI. RAGP was targeted anatomically from the right atrium (RA) at the postero-septal area below superior vena cava (SVC) and from the left atrium (LA) if needed. The aim was to achieve >30% increase in heart rate (HR) . The follow up consisted of regular visits and Holter ECG conducted every 3 months. Results A total number of 9 patients (age 52 ± 13) with vagally-mediated AF underwent RFCA of RAGP (mean RAGP RF time 147 ± 85, max power 34 ± 8W). The mean procedure time was 60 ± 29min. HR increase >30% was achieved in 8 (89%) patients (pre-RF vs post-RF: 58 ± 8bpm vs 87 ± 12bpm, p = 0.00002) . Transseptal  to reach RAGP also from the LA was needed in 2 (22%) patients. There were no major complications during the procedures. The follow up lasted 6 ± 2 months. Antiarrhythmic drugs were discontinued in 8 (89%) patients. There was 1 (11%) AF recurrence in the patient in whom targeted HR acceleration during RFCA was not achieved. B-blockers were administered in  6 (67%) patients due to increased HR and such treatment was well tolerated by all. Conclusions Catheter ablation of RAGP without performing PVI is feasible and can be effective in majority of patients with vagally-mediated AF. Increased HR after such cardioneuroablation can be well controlled using b-blockers and is usually associated with mild symptoms. The role of cardioneuroablation for treatment of vagally-mediated AF needs to be determined in prospective trials. Abstract Figure. Cardioneuroablation in vagal AF


EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
T Aksu ◽  
K Yalin ◽  
L John ◽  
J Osorio ◽  
J Winterfield ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. Background The effect of different anesthetics on the function of the autonomic nervous system (ANS) is not well known. As a relatively new treatment option, ganglionated plexus (GP) ablation aims to modify the behavior of the cardiac ANS to prevent some/all of the autonomic processes occurring in vasovagal syncope (VVS) by using endocardial ablation techniques. Purpose The purpose of this study was to determine the effects midazolam and propofol on the vagal response (VR) characteristics during GP ablation in patients with vasovagal syncope (VVS). Methods Forty consecutive patients undergoing GP ablation for VVS were divided to receive local anesthesia with midazolam (group 1, n = 29) or general anesthesia with propofol (group EA, n = 11). All GP sites were detected by using previously defined fragmented electrogram based strategy. VR was defined on 3 levels: 1) R-R interval increased by 50% (level 1); 2) R-R interval increased by 20-50% (level 2); and 3) R-R interval increase lower than 20% (level 3). Results Baseline characteristics and mean follow-up times were comparable between groups. In both groups, the left superior GP (LSGP) was the most common GP site at which a VR was observed. However, there was a significant difference between groups for level of VR. While ablation on the LSGP caused a level 1 VR in 89.6% of cases in group 1, level 1 VR was seen in 22.2% of cases in group 2 (p < 0.0001). Similarly, ratio of level 1 VR during ablation on the left inferior GP (LIGP) was significantly lower in group 2 (44.8% vs 9%, p = 0.034). Once cut-off for VR was decreased to level 2, the ratio of (+) VR increased to 90.9% during ablation on the LSGP in group 2. Level 2 VR was detected in 45.4% of cases during ablation on the LIGP. Ratio of positive VRs in any level was lower than 20% during ablation on the right superior and inferior GPs in both groups. During a mean follow-up time of 12.1 ± 7 months, all but 2 (5%) of 40 patients were free of syncope. Conclusions The autonomic nervous tone might be affected in different ways by local and general anesthesia. Propofol may reveal a shift in the sympathovagal balance toward sympathetic predominance which may cause a blunting on VR during GP ablation. Further randomized, controlled and multicenter studies should be performed to confirm these findings.


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