Computed tomography-based identification of ganglionated plexi to guide cardioneuroablation for vasovagal syncope

Abstract

Graphical Abstract RF RESPONSE Over EFP Outside EFP No resp A Ao-SVC GP 1/12 1/12 Volume: 434±94 mm3 10/12 (8%) (8%) fEGM: 1 (8%) (84%) LSGP 7/12 1/12 Volume: 152±20 mm3 4/12 L (58%) 5.6 mm (8%) fEGM: 7 (58%) (34%) MTGP 0/12 0/12 Volume: 173±31 mm3 12/12 (0%) (0%) fEGM: 3 (25%) (100%) LIGP 2/12 0/12 Volume: 174±35 mm3 10/12 (16%) (0%) fEGM: 2 (17%) (84%) B SPSGP 10/12 2/12 Volume: 481±104 mm3 0/12 (84%) (12%) fEGM: 4 (33%) (0%) L R RIGP 2/12 0/12 Volume: 218±55 mm3 10/12 (16%) (0%) fEGM: 2 (17%) (84%) IPSGP 3/12 1/12 Volume: 426±63 mm3 8/12 (25%) (8%) fEGM: 2 (17%) (67%) RF RESPONSE Over EFP Outside EFP No resp A Ao-SVC GP 1/12 1/12 Volume: 434±94 mm3 10/12 (8%) (8%) fEGM: 1 (8%) (84%) LSGP 7/12 1/12 Volume: 152±20 mm3 4/12 L (58%) 5.6 mm (8%) fEGM: 7 (58%) (34%) MTGP 0/12 0/12 Volume: 173±31 mm3 12/12 (0%) (0%) fEGM: 3 (25%) (100%) LIGP 2/12 0/12 Volume: 174±35 mm3 10/12 (16%) (0%) fEGM: 2 (17%) (84%) B SPSGP 10/12 2/12 Volume: 481±104 mm3 0/12 (84%) (16%) fEGM: 4 (33%) (0%) L R RIGP 2/12 0/12 Volume: 218±55 mm3 10/12 (16%) (0%) fEGM: 2 (17%) (84%) IPSGP 3/12 1/12 Volume: 426±63 mm3 8/12 (25%) (8%) fEGM: 2 (17%) (67%) Figure 1 Anatomic localization of epicardial fat pads (EFP) and corresponding ganglionated plexi (GPs). For each GP, radiofrequency (RF) response is reported according to the application site (over EFP, outside EFP, no response). (A) Disagreement between EFP and effective RF site at the level of the Ao-SVC GP. (B) In the same patient, effective RF over the EFP at the level of SPSGP. Ao-SVC GP, aorta-superior vena cava GP; IPSGP, inferior paraseptal GP; LIGP, left inferior GP; LSGP, left superior GP; MTGP, Marshall tract GP; RIGP, right inferior GP; SPSGP, superior paraseptal GP.