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

BackgroundThis study aims to evaluate the safety and efficacy of zero-ray radiofrequency ablation of the cardiac autonomic ganglionic plexus (GP) for treating vasovagal syncope (VVS) in young individuals undergoing high-intensity physical training.MethodsWe retrospectively analyzed data from 35 youn...

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Main Authors: Yan Guo, Si Li, Xiangyang Yang, Jiaman Hu, Jun Liu, Xiaolong Gu, Yanzhuo Li
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2025.1537827/full
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author Yan Guo
Si Li
Xiangyang Yang
Jiaman Hu
Jun Liu
Xiaolong Gu
Yanzhuo Li
author_facet Yan Guo
Si Li
Xiangyang Yang
Jiaman Hu
Jun Liu
Xiaolong Gu
Yanzhuo Li
author_sort Yan Guo
collection DOAJ
description BackgroundThis study aims to evaluate the safety and efficacy of zero-ray radiofrequency ablation of the cardiac autonomic ganglionic plexus (GP) for treating vasovagal syncope (VVS) in young individuals undergoing high-intensity physical training.MethodsWe retrospectively analyzed data from 35 young individuals with recurrent syncope (≥3 syncopal episodes within the year prior to the procedure) who underwent GP ablation at our hospital between May 2021 and January 2023. Among them, 33 (94.3%) were male, with a mean age of 22.7 ± 4.6 years. Systemic diseases and/or organic heart conditions that could cause syncope were excluded through comprehensive examinations upon admission. GP ablation was performed in patients with a positive upright tilt test. During the procedure, zero-ray septal puncture was guided by intracardiac ultrasound, and the GP was localized using the anatomical approach (AA) as the ablation target. The ablation endpoint was defined as an increase in heart rate to approximately 90 beats per minute. The safety and efficacy of the procedure were assessed by comparing preoperative and postoperative data, including heart rate, sinus node recovery time, atrioventricular (AV) Wenckebach point, heart rate variability (HRV), deceleration capacity of the heart (DC), and the occurrence of arrhythmias.ResultsNo intraoperative or postoperative complications were observed with zero-ray intracavitary ultrasound-guided GP ablation. Postoperatively, the sinus node recovery time and AV Wenckebach point were significantly shorter compared to preoperative values (P < 0.001). Both the postoperative mean ECG heart rate and the 12-month postoperative Holter mean heart rate were significantly higher than preoperative levels (P < 0.001). Additionally, sDANN-24, rMSSD, and deceleration capacity (DC) were significantly reduced postoperatively (P < 0.001). The follow-up period ranged from a minimum of 15 months to a maximum of 35 months. Within one year after surgery, two cases experienced a single episode of syncope, and one case reported a single episode of a syncopal premonitory aura. In the patient with a syncopal premonitory aura, outpatient ECG and Holter monitoring showed no abnormalities. The patient who experienced syncope was readmitted for further evaluation, including ECG, Holter monitoring, and an upright tilt test, which was negative. Two postoperative cases (one with a syncopal premonitory aura and one without syncope) exhibited second-degree type II AV block on Holter monitoring, which occurred during nocturnal sleep. Despite this, both groups were able to continue high-intensity physical training with significant symptomatic improvement.ConclusionsZero-ray cardiac GP ablation is a radiation-free, minimally invasive, safe, and effective treatment for young VVS patients undergoing high-intensity physical training.
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spelling doaj-art-deacf63dde4c4fe489fc35cd0ca209212025-08-20T03:06:42ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-04-011210.3389/fcvm.2025.15378271537827A study on the therapeutic effect of zero-ray cardiac autonomic ganglion ablation on vasovagal syncope in a special occupational young populationYan Guo0Si Li1Xiangyang Yang2Jiaman Hu3Jun Liu4Xiaolong Gu5Yanzhuo Li6General Hospital of Southern Theater Command, People's Liberation Army, Guangzhou, ChinaGeneral Hospital of Southern Theater Command, People's Liberation Army, Guangzhou, ChinaGeneral Hospital of Southern Theater Command, People's Liberation Army, Guangzhou, ChinaDepartment of Quality Management, Tianjin Rehabilitation Center, Tianjin, ChinaGeneral Hospital of Southern Theater Command, People's Liberation Army, Guangzhou, ChinaGeneral Hospital of Southern Theater Command, People's Liberation Army, Guangzhou, ChinaGeneral Hospital of Southern Theater Command, People's Liberation Army, Guangzhou, ChinaBackgroundThis study aims to evaluate the safety and efficacy of zero-ray radiofrequency ablation of the cardiac autonomic ganglionic plexus (GP) for treating vasovagal syncope (VVS) in young individuals undergoing high-intensity physical training.MethodsWe retrospectively analyzed data from 35 young individuals with recurrent syncope (≥3 syncopal episodes within the year prior to the procedure) who underwent GP ablation at our hospital between May 2021 and January 2023. Among them, 33 (94.3%) were male, with a mean age of 22.7 ± 4.6 years. Systemic diseases and/or organic heart conditions that could cause syncope were excluded through comprehensive examinations upon admission. GP ablation was performed in patients with a positive upright tilt test. During the procedure, zero-ray septal puncture was guided by intracardiac ultrasound, and the GP was localized using the anatomical approach (AA) as the ablation target. The ablation endpoint was defined as an increase in heart rate to approximately 90 beats per minute. The safety and efficacy of the procedure were assessed by comparing preoperative and postoperative data, including heart rate, sinus node recovery time, atrioventricular (AV) Wenckebach point, heart rate variability (HRV), deceleration capacity of the heart (DC), and the occurrence of arrhythmias.ResultsNo intraoperative or postoperative complications were observed with zero-ray intracavitary ultrasound-guided GP ablation. Postoperatively, the sinus node recovery time and AV Wenckebach point were significantly shorter compared to preoperative values (P < 0.001). Both the postoperative mean ECG heart rate and the 12-month postoperative Holter mean heart rate were significantly higher than preoperative levels (P < 0.001). Additionally, sDANN-24, rMSSD, and deceleration capacity (DC) were significantly reduced postoperatively (P < 0.001). The follow-up period ranged from a minimum of 15 months to a maximum of 35 months. Within one year after surgery, two cases experienced a single episode of syncope, and one case reported a single episode of a syncopal premonitory aura. In the patient with a syncopal premonitory aura, outpatient ECG and Holter monitoring showed no abnormalities. The patient who experienced syncope was readmitted for further evaluation, including ECG, Holter monitoring, and an upright tilt test, which was negative. Two postoperative cases (one with a syncopal premonitory aura and one without syncope) exhibited second-degree type II AV block on Holter monitoring, which occurred during nocturnal sleep. Despite this, both groups were able to continue high-intensity physical training with significant symptomatic improvement.ConclusionsZero-ray cardiac GP ablation is a radiation-free, minimally invasive, safe, and effective treatment for young VVS patients undergoing high-intensity physical training.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1537827/fullzero-rayanatomical localization methodablationhigh-intensity physical trainingyoung population
spellingShingle Yan Guo
Si Li
Xiangyang Yang
Jiaman Hu
Jun Liu
Xiaolong Gu
Yanzhuo Li
A study on the therapeutic effect of zero-ray cardiac autonomic ganglion ablation on vasovagal syncope in a special occupational young population
Frontiers in Cardiovascular Medicine
zero-ray
anatomical localization method
ablation
high-intensity physical training
young population
title A study on the therapeutic effect of zero-ray cardiac autonomic ganglion ablation on vasovagal syncope in a special occupational young population
title_full A study on the therapeutic effect of zero-ray cardiac autonomic ganglion ablation on vasovagal syncope in a special occupational young population
title_fullStr A study on the therapeutic effect of zero-ray cardiac autonomic ganglion ablation on vasovagal syncope in a special occupational young population
title_full_unstemmed A study on the therapeutic effect of zero-ray cardiac autonomic ganglion ablation on vasovagal syncope in a special occupational young population
title_short A study on the therapeutic effect of zero-ray cardiac autonomic ganglion ablation on vasovagal syncope in a special occupational young population
title_sort study on the therapeutic effect of zero ray cardiac autonomic ganglion ablation on vasovagal syncope in a special occupational young population
topic zero-ray
anatomical localization method
ablation
high-intensity physical training
young population
url https://www.frontiersin.org/articles/10.3389/fcvm.2025.1537827/full
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