Arq. Bras. Cardiol. 2017; 109(5): 384-386
Cardiac Autonomic Modulation – The Search for an Ultimate Technique
DOI: 10.5935/abc.20170166
Abnormal parasympathetic activity on the heart has been implicated in several forms of symptomatic bradycardia, especially in young and otherwise healthy individuals. Neurally mediated syncope, sinus arrest and advanced atrioventricular (AV) block have high risk of injury and serious implications on quality of life. Nonetheless, until recently, their clinical management, mainly based on behavioral measures and pacing, have often proved to be ineffective or inadequate. An alternative approach to treat this specific population, avoiding device implants and continuous drug therapy seemed to be required.
Ganglionated plexus (GP) ablation was first described in 2005, with the purpose of targeting the main parasympathetic ganglia and promoting a vagal attenuation. During the last decade, several authors– presented their clinical results, with significant remission of symptoms and electrocardiographic improvement, and autonomic modulation became an established therapeutic modality.
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