Cardioinhibitory syncope: from pathophysiology to treatment—should we think on cardioneuroablation?

  title={Cardioinhibitory syncope: from pathophysiology to treatment—should we think on cardioneuroablation?},
  author={Alan Garcia and Manlio F. M{\'a}rquez and Emilse F. Fierro and J J Baez and Leyla P. Rockbrand and Jorge Gomez-Flores},
  journal={Journal of Interventional Cardiac Electrophysiology},
Vasovagal syncope (VVS) is the most common type of syncope; the lone cardioinhibitory syncope represents only a small group of patients; however, the “cardioinhibitory component” is highly prevalent in reflex syncope and can be severe enough to produce asystole, lasting for a few seconds followed by a recovery to sinus beats. The environment in which syncope occurs can compromise life, and in-depth knowledge of the disease can prevent deaths and guide the appropriate management. The therapeutic… 
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Effusive pericarditis in the pathogenesis of cardiac arrhythmias in COVID-19: a case series

A wide variety of non-pulmonary manifestations of a coronavirus disease 2019 (COVID-19) has enriched clinical performance of cardiac diseases with atypical symptoms, and three cases are presented, where sinus bradycardia and syncope were the leading ones after the infection.

Clinical values of creatine kinase and its isoenzymes in children and adolescents with vasovagal syncope.

Vasovagal Syncope.



Cardioneuroablation in the treatment of neurally mediated reflex syncope: a review of the current literature.

Focused or extensive vagal ganglia ablation may be a potential alternative to pacemaker implantation in a carefully selected patient population of patients with NMRS.

Ganglionated plexi ablation in right atrium to treat cardioinhibitory neurocardiogenic syncope

The case of two patients with frequent episodes of CNS withmarked cardioinhibitory response at head-up tilt test (HUT) who remained highly symptomatic despite common therapeutic measures is reported.

Rationale for the prevention of syncope trial IV: assessment of midodrine

This study will be the first adequately powered trial to determine whether midodrine is effective in preventing vasovagal syncope, and if it is effective, then it may become the first-line pharmacological therapy for this condition.

The Elusive Pathophysiology of Neurally Mediated Syncope

This review critically evaluates proposed theories that attempt to explain the pathophysiological mechanisms of Neurally mediated syncope (NMS), a common clinical problem that affects up to 3.5% of the general population.

Stop vasodepressor drugs in reflex syncope: a randomised controlled trial

Recurrence of syncope and presyncope can be reduced by discontinuing/reducing vasoactive therapy in most elderly patients affected by reflex vasodepressor syncope.

Neurocardiogenic Syncope

The authors have found that the heart rate recovery index was significantly greater in the neurocardioIn this issue of Cardiology, Kocabaş et al. report a novel method for the diagnosis of neurocardiogenic syncope, a reflex response resulting in vasodilation and bradycardia, and propose a novel testing method which is based on a maximal or submaximal exercise test and theheart rate recovery following the exercise.

Mechanism of Syncope in Patients With Isolated Syncope and in Patients With Tilt-Positive Syncope

In most patients, the likely cause was neurally-mediated, and the most frequent mechanism was a bradycardic reflex, while in the other cases, a normal sinus rhythm was frequently recorded.

International study on syncope of uncertain aetiology 3 (ISSUE 3): pacemaker therapy for patients with asystolic neurally-mediated syncope: rationale and study design.

  • M. Brignole
  • Medicine
    Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
  • 2007
P pacing therapy is evaluated for preventing syncope recurrence in patients with a high probability of cardio-inhibitory neurally-mediated syncope and one or more of the following are excluded: carotid sinus syndrome; suspected or definite heart disease and high likelihood of cardiac syncope.

Differential effects of ganglionic plexi ablation in a patient with neurally mediated syncope and intermittent atrioventricular block: a commentary.

The main objective of CNA is the parasympathetic denervation of the heart to allow the treatment of bradyarrhythmias symptomatic reflex (neurocardiogenic syncope) and/or functional (sinus node dysfunction and functional atrioventricular (AV) block).

The different clinical presentations of vasovagal syncope

For some decades, after the introduction of the head-up tilt test into clinical practice, the clinical presentation of vasovagal syncope (VVS) has been classified as typical (or classical) and