Ganglia, Autonomic – ABC CARDIOL

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Editorial

Ganglionated Plexi Ablation to Treat Patients with Refractory Neurally Mediated Syncope and Severe Vagal-Induced Bradycardia

Mauricio Scanavacca et al. Denise Hachul

Neurally mediated syndrome (NMS) is the most common cause of and transient loss of consciousness and usually causes anxiety and concerns for patients and their families. Clinical investigation and explanations about benignity, in association to lifestyle modifications and teaching methods to abort the vagal reflex are the initial and effective approaches to manage the majority of patients.^–

However, in some cases, the loss of consciousness occurs suddenly, without prodromal symptoms and the patient does not have the opportunity to prevent falls, which may lead to severe physical trauma. Specific medications have been proposed trying to control the symptoms and pacemaker implantation has been recommended in the refractory cases of cardioinhibitory reflexes.^–

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ABC

Editorial

Cardiac Autonomic Modulation – The Search for an Ultimate Technique

Esteban Rivarola et al. Mauricio Scanavacca

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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Ganglionated Plexi Ablation to Treat Patients with Refractory Neurally Mediated Syncope and Severe Vagal-Induced Bradycardia

Cardiac Autonomic Modulation – The Search for an Ultimate Technique

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Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)