A study on the therapeutic effect of zero-ray cardiac autonomic ganglion ablation on vasovagal syncope in a special occupational young population

Yan Guo ¹ Si Li ¹ Xiangyang Yang ¹ Jiaman HU ² Jun Liu ¹ Xiaolong Gu ¹ Yanzhuo Li ^1,3*

• ¹ People's Liberation Army General Hospital of Southern Theatre Command, Guangzhou, China
• ² Department of Quality Management, Tianjin Rehabilitation Center, 300000, China, Tianjin, China
• ³ General Hospital of Southern Theater Command of the Chinese People's Liberation Army, Guangzhou, China

Background: To investigate the safety and efficacy of zero-ray radiofrequency ablation of the cardiac autonomic ganglionic plexus (GP) for the treatment of vasovagal syncope (VVS) in a young population with high-intensity physical training.Method: Data from 35 cases of recurrent syncope in young people with high-intensity physical training who underwent GP ablation in our hospital were reviewed and analyzed. Among them, 33 cases (94.3%) were male with a mean age of 22.7±4.6 years. Zero-ray septal puncture guided by intracardiac ultrasound was used during the procedure, and the GP localized by the anatomical approach (AA) was the target of ablation, and the heart rate was increased to about 90 beats/min as the termination criterion of ablation, and the safety and efficacy of the procedure were analyzed after comparing the preoperative and postoperative data of the heart rate, the sinus node recovery time, the AV Wenckebach point, the heart rate variability (HRV), the decelerating capacity of the heart (DC), and arrhythmia, and so on. Effectiveness.Results: There were no intraoperative and postoperative complications of zero-ray intracavitary ultrasound-guided GP ablation. The sinus node recovery time and the AV Wenckebach point were shorter postoperatively than preoperatively (P<0.001). Postoperative mean ECG heart rate and 12-month postoperative holter mean heart rate were faster than preoperative (P<0.001). sDANN-24, rMSSD, and DC were reduced compared with preoperative (P<0.001). The minimum follow-up was 15 months and the maximum was 35 months. 2 cases of syncope 1 time and 1 case of syncopal premonitory aura 1 time were seen within 1 year after surgery. The outpatient review of EGC and holter was normal in the case of syncope precursor, and the syncope case was readmitted to the hospital for review of ECG and holter, and the upright tilt test was negative. Both groups were able to continue to complete high-intensity physical training with significant improvement in symptoms.Conclusions: Zero-ray cardiac GP ablation is a radiation-free, minimally invasive, safe and effective treatment for young VVS patients with high-intensity physical training.