Ablation of myocardial autonomic ganglion plexus in the treatment of bradyarrhythmia A one-arm interventional study

ABSTRACT

Objectives:

To study the complications and effectiveness of the treatment of chronic arrhythmias with cardiac Ganglion Plexus (GP) ablation, and to explore the value of the treatment of chronic arrhythmias with GP ablation.

Methods:

This study was a one-arm interventional study of patients from the first hospital of Xinjiang Medical University and the People’s Hospital of Xuancheng City admitted (09/2018-08/2021) because of bradyarrhythmia. The left atrium was modeled using the Carto3 mapping system. The ablation endpoint was the absence of a vagal response under anatomically localized and high-frequency stimulation guidance. Postoperative routine follow-up was conducted. Holter data at 3-, 6-, and 12-months were recorded.

Results:

Fifty patients (25 male, mean age 33.16 ± 7.89 years) were induced vagal response by either LSGP, LIGP, RAGP, or RIGP. The heart rate was stable at 76 bpm, SNRT 1.092s. DC, DR, HR, SDNN, RMSSD values were lower than that before ablation. AC, SSR, TH values were higher than those before ablation, mean heart rate and the slowest heart rate were significantly increased. There were significant differences in follow-up data between the preoperative and postoperative periods (all p < 0.05). All the patients were successfully ablated, and their blood pressure decreased significantly. No complications such as vascular damage, vascular embolism and pericardial effusion occurred.

Conclusions:

Left Atrial GP ablation has good long-term clinical results and can be used as a treatment option for patients with bradyarrhythmia.

Keywords:
Ganglion plexus; 3D mapping; Ablation; Bradyarrhythmia; Interventional study

HIGHLIGHTS

SNRT 1.092s. DC, DR, HR, SDNN, RMSSD value are lower after ablation.

AC, SSR, TH value were higher after ablation.

No complications occurred after ablation.

Left Atrial GP ablation has good long-term clinical results for bradyarrhythmia.