30 April, 2024

Cardioneuroablation, a new treatment for vasovagal syncope, available at barnaclínic+

Continuous research and technological development make it possible to offer new solutions in medicine that overcome the challenges that have existed until then and that serve to improve patient outcomes. One of these new solutions is cardioneuroablation, a procedure capable of specifically and effectively addressing a medical condition that can have a significant impact on patients’ quality of life: vasovagal syncope. barnaclínic+, faithful to its spirit of innovation, now offers this new procedure.

WHAT IS CARDIONEUROABBLATION OR CARDIO NEUROMODULATION?

Cardioneuroablation, also known as cardio neuromodulation, represents a cutting-edge advance in cardiovascular medicine. “This procedure focuses on the modification of neurocardiac responses using highly specialised and highly focused catheter ablation techniques,” explains Dr Andreu Porta, associate physician at the Arrhythmia Unit of the Cardiology Service at hospital Clínic Barcelona and specialist in barnaclínic+.

“This procedure focuses on the modification of neurocardiac responses using highly specialised and highly focused catheter ablation techniques”

Dr Andreu Porta, associate physician at the Arrhythmia Unit of the Cardiology Service at hospital Clínic Barcelona and specialist in barnaclínic+

The fact that we can now offer the innovative cardioneuroablation at barnaclínic+ is due to the fact that our arrhythmia section is one of the most cutting-edge units in the world for the treatment and management of arrhythmias using catheter ablation techniques. “Given that this is a procedure performed using a catheter in a minimally invasive manner and with the help of 3D navigation, experience in performing ablations of all types is required, and our centre and our specialists have it,” adds Dr Porta.

THE SOLUTION FOR VASOVAGAL SYNCOPE, A LIMITING CONDITION

Vasovagal syncope, also known as neurocardiogenic syncope or simply reflex syncope, is a disorder in which a person experiences a temporary loss of consciousness due to an abnormal response of the autonomic nervous system. This response can be triggered by various factors, such as emotional stress, pain, fear, the sight of blood or wounds, standing for a long time, or even the feeling of blockage when urinating or defecating.

In vasovagal syncope, exaggerated activation of the vagus nerve, which is part of the autonomic nervous system and plays an important role in regulating heart rate and blood pressure, leads to a temporary decrease in blood flow to the brain. This causes a loss of consciousness and, in some cases, may be accompanied by involuntary movements such as tremors or seizures.

Although vasovagal syncope is not usually life-threatening, it can be worrying and significantly affect the quality of life of those who experience it, especially if episodes are recurrent or occur in potentially dangerous situations, such as when operating machinery or driving a vehicle. “There are some patients who present a very marked response with a drop-in heart rate, which is called cardio inhibition and it is in these patients that we can act through cardioneuroablation,” explains the barnaclínic+ expert.

“There are some patients who present a very marked response with a drop-in heart rate, which is called cardio inhibition and it is in these patients that we can act through cardioneuroablation”

Dr Andreu Porta, associate physician at the Arrhythmia Unit of the Cardiology Service at hospital Clínic Barcelona and specialist in barnaclínic+

In this way, cardioneuroablation is used in situations where the activity of the autonomic nervous system contributes significantly to the appearance of syncope due to a decrease in heart rate, being used in selected cases in which the symptoms of reflex syncope are very repetitive or occur in contexts in which they significantly affect the quality of life.

CARDIONEUROABBLATION STEP BY STEP, A VERY DIRECTED PROCEDURE

To treat vasovagal syncope with cardioneuroablation, it is first necessary to identify the areas of the heart responsible for the drop-in heart rate. The heart is then accessed through the femoral vein, using catheterization techniques under general anaesthesia. “Once inside the heart, a three-dimensional navigation system is used to precisely identify the specific areas of the cardiac atria, both right and left, where the ganglia responsible for regulating the activity of the vagus nerve are located. These nodes, when identified, are treated with radiofrequency energy, a technique that allows their function to be modified with high precision,” says Dr Porta.

During cardioneuroablation, a careful evaluation of the response of the autonomic nervous system is carried out by stimulating various points, thus ensuring that the modulation of vagal activity is adequate and effective. This process, which usually lasts between 30 minutes and 1 hour, is performed by a highly specialised team of medical professionals.

After cardioneuroablation, the patient usually requires a period of rest to recover before being discharged. While each case may vary slightly, in general, most patients are able to return home within a few hours after the procedure. This innovative approach offers a promising alternative for those patients facing the challenges of vasovagal syncope, providing a more precise and targeted treatment option.

CARDIONEUROMODULATION, AN OPTION FOR VERY YOUNG PATIENTS

To date, the predominant treatment for cases of vasovagal syncope with exaggerated vagal activity involved the implantation of a permanent pacemaker, especially in those patients whose symptoms were recurrent or significantly impacted their quality of life. However, this option posed significant challenges, especially for young patients, who could face long-term complications due to the need to wear an implanted device for life.

“The arrival of cardioneuroablation marks a milestone in the field of cardiovascular medicine by offering a more attractive and less invasive alternative for these patients. By avoiding the need for a permanent pacemaker, it not only effectively addresses the symptoms of vasovagal syncope, but also minimises the concerns associated with surgical intervention and long-term maintenance of the device,” says Dr Porta.

“The arrival of cardioneuroablation marks a milestone in the field of cardiovascular medicine by offering a more attractive and less invasive alternative for these patients. By avoiding the need for a permanent pacemaker, it not only effectively addresses the symptoms of vasovagal syncope”

Dr Andreu Porta, associate physician at the Arrhythmia Unit of the Cardiology Service at hospital Clínic Barcelona and specialist in barnaclínic+

The new cardioneuroablation, which is now available at barnaclínic+, represents a considerable advance in medical care, providing a personalised solution adapted to the specific needs of each patient. Furthermore, by offering an attractive alternative for young patients, it improves the quality of life and long-term well-being of those facing the challenges of vasovagal syncope.