51. Effects of permanent cardiac pacing on ventricular repolarization when compared to cardioneuroablation
- Author
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Deepak Padmanabhan, Mohit K. Turagam, Tolga Aksu, Krishna Akella, Jayaprakash Shenthar, Rakesh Gopinathannair, Andrea Natale, Sandeep Gautam, Erkan Baysal, Kivanc Yalin, Dhanunjaya Lakkireddy, Piotr Futyma, and Serdar Bozyel
- Subjects
Adult ,Male ,Ventricular Repolarization ,medicine.medical_specialty ,Cardiac pacing ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,QT interval ,Electrocardiography ,03 medical and health sciences ,0302 clinical medicine ,Heart Rate ,Tilt-Table Test ,Internal medicine ,Neuromodulation ,Syncope, Vasovagal ,Humans ,Medicine ,cardiovascular diseases ,030212 general & internal medicine ,Vasovagal syncope ,business.industry ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,Cardioneuroablation ,Clinical diagnosis ,Catheter Ablation ,cardiovascular system ,Cardiology ,Female ,Cardiac monitoring ,Cardiology and Cardiovascular Medicine ,business - Abstract
The impact of cardioneuroablation (CNA) on ventricular repolarization by using corrected QT interval (QTc) measurements has been recently demonstrated. The effects of cardiac pacing (CP) on ventricular repolarization have not been studied in patients with vasovagal syncope (VVS). We sought to compare ventricular repolarization effects of CNA (group 1) with CP (group 2) in patients with VVS.We enrolled 69 patients with age 38 ± 13 years (53.6% male), n = 47 in group 1 and n = 22 in group 2. Clinical diagnosis of cardioinhibitory type was supported by cardiac monitoring or tilt testing. QTc was calculated at baseline (time-1), at 24 h after ablation (time-2), and at 9-12 months (time-3) in the follow-up.In the group 1, from time-1 to time-2, a significant shortening in QTcFredericia (from 403 ± 27 to 382 ± 27 ms, p0.0001), QTcFramingham (from 402 ± 27 to 384 ± 27 ms, p0.0001), and QTcHodges (from 405 ± 26 to 388 ± 24 ms, p0.0001) was observed which remained lower than baseline in time-3 (373 ± 29, 376 ± 27, and 378 ± 27 ms, respectively). Although the difference between measurements in time-1 and time-2 was not statistically significant for QTcBazett, a significant shortening was detected between time-1 and time-3 (from 408 ± 30 to 394 ± 33, p = 0.005). In the group 2, there was no time-based changes on QTc measurements. In the linear mixed model analysis, the longitudinal reduction tendency in the QTcFredericia and QTcFramingham was more pronounced in group 1.Our results demonstrate that CNA reduces QTc levels through neuromodulation effect whereas CP has no effect on ventricular repolarization in patients with VVS.
- Published
- 2021