{"id":2043,"date":"2022-09-21T18:55:25","date_gmt":"2022-09-21T16:55:25","guid":{"rendered":"https:\/\/rythmologie.fr\/v2\/?p=2043"},"modified":"2022-10-21T10:12:55","modified_gmt":"2022-10-21T08:12:55","slug":"newsletter-mai-2022-feasability-and-safety-of-catheter-based-cardioneural-ablation-results-from-the-multicentre-us-can-registry-by-roderick-tung","status":"publish","type":"post","link":"https:\/\/rythmologie.fr\/index\/newsletter-mai-2022-feasability-and-safety-of-catheter-based-cardioneural-ablation-results-from-the-multicentre-us-can-registry-by-roderick-tung\/","title":{"rendered":" Newsletter Mai 2022 &#8211; Feasability and safety ..."},"content":{"rendered":"<p>[vc_row][vc_column css=&#8221;.vc_custom_1663235123898{margin-top: 0px !important;border-top-width: 0px !important;background-color: rgba(255,255,255,0.1) !important;*background-color: rgb(255,255,255) !important;}&#8221;]<div id=\"ultimate-heading-92006a0a18a2df081\" class=\"uvc-heading ult-adjust-bottom-margin ultimate-heading-92006a0a18a2df081 uvc-7644  uvc-heading-default-font-sizes\" data-hspacer=\"no_spacer\"  data-halign=\"center\" style=\"text-align:center\"><div class=\"uvc-heading-spacer no_spacer\" style=\"top\"><\/div><div class=\"uvc-main-heading ult-responsive\"  data-ultimate-target='.uvc-heading.ultimate-heading-92006a0a18a2df081 h2'  data-responsive-json-new='{\"font-size\":\"\",\"line-height\":\"\"}' ><h2 style=\"--font-weight:theme;\">Newsletter Groupe Rythmologie \u2013 Stimulation cardiaque de la SFC<\/h2><\/div><div class=\"uvc-sub-heading ult-responsive\"  data-ultimate-target='.uvc-heading.ultimate-heading-92006a0a18a2df081 .uvc-sub-heading '  data-responsive-json-new='{\"font-size\":\"\",\"line-height\":\"\"}'  style=\"font-weight:normal;\">Mai 2022<\/div><\/div>[vc_empty_space height=&#8221;24px&#8221;][vc_column_text]<i><span style=\"font-weight: 400;\">Chers amis, <\/span><\/i><\/p>\n<p><i><span style=\"font-weight: 400;\">Quelques semaines apr\u00e8s le congr\u00e8s EHRA, s\u2019est tenu le congr\u00e8s de la Heart Rhythm Society (HRS) \u00e0 San Francisco du 29 avril au 1er mai 2022. Apr\u00e8s 2 ans de crise dont un congr\u00e8s 2021 en format tr\u00e8s r\u00e9duit, plus de 5700 participants, pr\u00e9sents ou online ont pu \u00e9changer durant ces journ\u00e9es tr\u00e8s productives. Parmi les 250 sessions, nous avons s\u00e9lectionn\u00e9 pour vous les \u00e9tudes les plus int\u00e9ressantes des \u00ab Late breaking \u00bb.<\/span><\/i><\/p>\n<p><i><span style=\"font-weight: 400;\">Les sujets sont vari\u00e9s : ablation \u00e9picardique dans le syndrome de Brugada, nouvelles \u00e9nergies avec la radiofr\u00e9quence \u00ab high power \u00bb pour l\u2019ablation de la FA, \u00e9tude randomis\u00e9e comparant stimulation de la branche gauche et resynchronisation standard, \u00e9tude comparant d\u00e9fibrillateur sous cutan\u00e9 et transveineux, ablation du parasympathique dans l\u2019OG dans les syncopes vagales etc&#8230; <\/span><\/i><\/p>\n<p><i><span style=\"font-weight: 400;\">Nous vous souhaitons, au nom du groupe de rythmologie, une excellente lecture<\/span><\/i><\/p>\n<p><i><span style=\"font-weight: 400;\">Pascal Defaye <\/span><\/i><\/p>\n<p><i><span style=\"font-weight: 400;\">Pr\u00e9sident du groupe de Rythmologie et Stimulation Cardiaque de la SFC<\/span><\/i>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]<\/p>\n<h3><b>Feasability and safety of catheter based Cardioneural Ablation. Results from the multicentre US CAN registry<\/b><span style=\"font-weight: 400;\"> By Roderick Tung<\/span><\/h3>\n<p>&nbsp;<\/p>\n<p><b>But de l\u2019\u00e9tude : <\/b><span style=\"font-weight: 400;\">\u00c9valuer la s\u00e9curit\u00e9 et l\u2019efficacit\u00e9 de l\u2019ablation des plexi ganglionnaires paracardiaques pour le traitement des bradycardies vagales symptomatiques et des syncopes neurocardiogeniques.<\/span><\/p>\n<p><b>Design de l\u2019\u00e9tude :<\/b><span style=\"font-weight: 400;\"> Registre multicentrique r\u00e9trospectif des cas cons\u00e9cutifs de cardioneuro-ablation r\u00e9alis\u00e9s dans 13 centres am\u00e9ricains entre 2015 et 2022<\/span><\/p>\n<p><b>Crit\u00e8res d\u2019inclusion :<\/b><span style=\"font-weight: 400;\"> Patients de plus de 18 ans avec des sympt\u00f4mes li\u00e9s \u00e0 des bradycardies sinusales, du BAV vagal et\/ou des syncopes vaso-vagales. Les \u00e9v\u00e8nements devaient \u00eatre enregistr\u00e9s lors d\u2019un holter, chez des patients avec un holter implantable ou lors d\u2019un tilt-test pour avoir une concordance \u00e9lectro-clinique.\u00a0<\/span><\/p>\n<p><i><span style=\"font-weight: 400;\">Inclusion m\u00eame si ablation d\u2019arythmie cardiaque concomitante.<\/span><\/i><\/p>\n<p>&nbsp;<\/p>\n<p><b>R\u00e9sultats\u00a0<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">76 proc\u00e9dures chez 71 patients (47 \u00b117 ans, 51% de femme)\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">63% avaient l\u2019ablation d\u2019une arythmie dans le m\u00eame++ temps (86% FA ou flutter, 14% autres tachycardies supra-ventriculaires)\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">localisation des sites \u00e0 traiter par stimulation haute fr\u00e9quence dans 42% des cas, mais \u00e9galement par cartographie des potentiels fragment\u00e9s (OD et OG) (figure) \u2192 R\u00e9ponses vagales \u00e0 la stimulation haute-fr\u00e9quence : 44% Plexus ganglionnaire sup\u00e9rieur gauche, 27% plexus ganglionnaire \u00e0 la jonction veine cave sup\u00e9rieure\/Aorte mais \u00e9galement des r\u00e9ponses sympatiques chez certains patients sur ce site, 24% Plexus ganglionnaire inf\u00e9rieur gauche.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">la fr\u00e9quence cardiaque a augment\u00e9 de 57 \u00e0 77 bpm en post ablation (p&gt;0.001) &#8211; 612 secondes de RF pour faire cette ablation &#8211; 3 complications (4%) : 1 tamponnade et 2 patients avec rythme jonctionnel\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Suivi \u00e0 8,5 mois, 82% n\u2019avaient plus de syncope (m\u00e9diane de 6 syncopes par patient avant la proc\u00e9dure \u00e0 0 apr\u00e8s)<\/span><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><b>Discussion<\/b><\/p>\n<p><span style=\"font-weight: 400;\">Il est difficile de tirer des conclusions de cette \u00e9tude compte tenu de son design.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Les \u00e9l\u00e9ments qui n\u00e9cessitent d\u2019\u00eatre clarifi\u00e9s pour d\u00e9velopper la cardioneuromodulation sont :\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">La s\u00e9lection des patients (patients relativement \u00e2g\u00e9s dans cette s\u00e9rie avec des sympt\u00f4mes variables)\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">L\u2019identification des zones \u00e0 cibler\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Crit\u00e8res plus pr\u00e9cis d\u2019efficacit\u00e9 des applications (quelle dur\u00e9e d\u2019application ? pour obtenir quel r\u00e9sultat ?)\u00a0<\/span><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><span style=\"font-weight: 400;\">Beaucoup d\u2019autres questions persistent : Quid de la variabilit\u00e9 du rythme sinusal ? Quelle est la dur\u00e9e d\u2019efficacit\u00e9 ? quelle est la part de l\u2019effet placebo ?<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Par ailleurs, 63% des patients venaient pour l\u2019ablation d\u2019une arythmie, ce qui n\u2019est g\u00e9n\u00e9ralement pas le cas des patients venant pour syncope vaso-vagale qui sont g\u00e9n\u00e9ralement plus jeunes.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Tout patient chez qui il est r\u00e9alis\u00e9 ce type de proc\u00e9dure devrait \u00eatre inclus dans un registre prospectif afin d\u2019avoir des informations sur le devenir de ces patients.<\/span>[\/vc_column_text][vc_single_image image=&#8221;2017&#8243; img_size=&#8221;full&#8221; alignment=&#8221;center&#8221; image_hovers=&#8221;false&#8221;][\/vc_column][\/vc_row][vc_row][vc_column][vc_empty_space]<div class=\" ubtn-ctn-center \"><a class=\"ubtn-link ult-adjust-bottom-margin ubtn-center ubtn-large \" href=\"https:\/\/rythmologie.fr\/wp-content\/uploads\/2022\/10\/05-Newsletter-Groupe-Rythmo-HRS-2022-3.pdf\" target=\"_blank\" rel=\"nofollow  noopener\" ><button type=\"button\" id=\"ubtn-9282\"  class=\"ubtn ult-adjust-bottom-margin ult-responsive ubtn-large ubtn-no-hover-bg  none  ubtn-center   tooltip-6a0a18a2df0d5\"  data-hover=\"#e42925\" data-border-color=\"\" data-bg=\"rgba(0,0,0,0.1)\" data-hover-bg=\"#ffffff\" data-border-hover=\"\" data-shadow-hover=\"\" data-shadow-click=\"none\" data-shadow=\"\" data-shd-shadow=\"\"  data-ultimate-target='#ubtn-9282'  data-responsive-json-new='{\"font-size\":\"\",\"line-height\":\"\"}'  style=\"font-family:&#039;Montserrat&#039;;font-weight:800;border:none;background: rgba(0,0,0,0.1);color: #000000;\"><span class=\"ubtn-hover\" style=\"background-color:#ffffff\"><\/span><span class=\"ubtn-data ubtn-text \" >T\u00e9l\u00e9charger toute la newsletter<\/span><\/button><\/a><\/div>[vc_empty_space][vc_separator][\/vc_column][\/vc_row]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>[vc_row][vc_column css=&#8221;.vc_custom_1663235123898{margin-top: 0px !important;border-top-width: 0px !important;background-color: rgba(255,255,255,0.1) !important;*background-color: rgb(255,255,255) !important;}&#8221;][vc_empty_space height=&#8221;24px&#8221;][vc_column_text]Chers amis, Quelques semaines apr\u00e8s le congr\u00e8s EHRA, s\u2019est tenu le congr\u00e8s de la Heart Rhythm Society (HRS) \u00e0 San Francisco du 29 avril au 1er mai 2022. Apr\u00e8s 2 ans de crise dont un congr\u00e8s 2021 en format tr\u00e8s r\u00e9duit, plus de 5700 participants,&hellip;<\/p>\n","protected":false},"author":2,"featured_media":2053,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"footnotes":"","_links_to":"","_links_to_target":""},"categories":[31,22],"tags":[],"class_list":["post-2043","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-newsletter","category-articles","category-31","category-22","description-off"],"_links":{"self":[{"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/posts\/2043","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/comments?post=2043"}],"version-history":[{"count":3,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/posts\/2043\/revisions"}],"predecessor-version":[{"id":2261,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/posts\/2043\/revisions\/2261"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/media\/2053"}],"wp:attachment":[{"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/media?parent=2043"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/categories?post=2043"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/tags?post=2043"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}