Статья
Кардионейроаблация в лечении нейрокардиогенных обмороков и функциональных брадиаритмий. Обзор литературы
Не угасает интерес к автономной нервной регуляции сердечно-сосудистой системы. Изменения активности автономной нервной системы участвуют в патогенезе острых и хронических состояний, таких как синусовая брадикардия, остановка синусового узла и атриовентрикулярная блокада, вазовагальный обморок и другие типы синкопальных состояний. Традиционные способы профилактики и лечения подобных состояний включают изменения образа жизни, фармакотерапию и, в определенных обстоятельствах, имплантацию электрокардиостимулятора, однако во многих случаях они не способны ни устранить симптомы, ни излечить данное заболевание. Мы провели описательный обзор наиболее значимых публикаций, посвященных исследованию эффективности и разработке методики кардионейроаблации у пациентов с вазовагальными обмороками и нейрогенными функциональными брадиаритмиями — дисфункцией синусового узла и нарушениями атриовентрикулярной проводимости. Эта методика позволяет эффективно предупреждать рецидивы нейрокардиогенных обмороков, снижать склонность к функциональным брадиаритмиям за счет устранения патологического парасимпатического тонуса от сердца. Кардионейроаблация позволяет устранить показания для имплантации электрокардиостимулятора или отсрочить ее выполнение.
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