Catheter Ablation of Cardiac Fat Pads Attenuates Bezold-Jarisch Reflex in Dogs

Abstract

RFCA of the cardiac FPs significantly attenuated veratridine-induced cardio-vagal component but not the vasodepressor component of the BJR. This might have therapeutic implications in BJR-related disorders such as cardio-inhibitory vasovagal syncope.

A fatal complication arising during pulmonic balloon valvuloplasty in a seven‐month‐old female bulldog

“…While it is known that atropinisation blocks efferent vagal activity, the effects on vagal afferent activity are less significant (De Behnke and others 1995). Since activation of vagal afferent activity is the mechanism believed to mediate cardioinhibition associated with the BJR (Xia and others 2011), this may explain why atropine was ineffective in this case. Alternatively, a paradoxical transient reduction in HR may occur after intravenous atropine.…”

Efficacy of cardioneurablation for vasodepressor vasovagal syncope

“…Therefore, it has a better effect on patients with cardioinhibitory and mixed VVS, which are caused by excessive activation of vagus nerve function. Xia [10] et al found significant improvement in symptoms of cardiac depression but not vascular depression when the vagal reflex was repeatedly induced after ablation of the epicardial fat pad in dogs. Their analysis was driven by the fact that radiofrequency ablation of the cardiac GP significantly attenuated the cardiac vagal component but had no effect on the vasodepressor component of the Bezold-Jarisch reflex.…”

“…In two studies, Pachon et al showed that permanent endocardial denervation can be achieved to treat VVS by catheter ablation of epicardial ganglia in the atrial wall from the endocardial surface [4,11]. Clinical research has demonstrated that catheter ablation can significantly improve symptoms in patients with VVS [10].…”

“…Cardiac postganglionic parasympathetic neurons, which are mainly located in the epicardial fat pad, regulate cardiac rhythm and conduction [4,8]. In preliminary studies, cardioneuroablation (CNA) was effective in treating VVS and achieved good long-term outcomes [9,10]. However, its effectiveness varies among patients with different types of VVS.…”

Another Step Forward: Journal of Cardiovascular Electrophysiology Special Issue for Electrophysiology Research from China

“…We would like to touch a little bit on the research from China based on the papers published in JCE in recent years. It is quite obvious that we have more clinical papers than basic research ones, the latter being focused mainly on autonomic nervous system, 1–5 besides one on a domestically made new product 6 and others 7 . For the clinical studies, we definitely have many more catheter ablation related papers than device relevant ones.…”