A procedure conducted for the first time in the United States at the University of Chicago Medicine has provided much-needed relief for a patient who suffered from recurrent fainting spells.
Called cardioneural ablation, the procedure essentially rewired the heart to treat the recurring sudden drops in heart rate and blood pressure that had been causing the 52-year-old woman to faint at least once every two months for most of her life.
This type of ablation—performed by Assoc. Prof. Roderick Tung, an internationally known expert on advanced therapies for heart rhythm disorders—had been performed in Europe, South America and Asia, but not in the U.S. However, Tung and his team wanted to help give the patient the relief she could not find with other therapies.
Since having the ablation a year and a half ago, the woman has not fainted, even in situations where she would normally faint, such as having her blood drawn.
“We have been following the data from other countries very carefully, and it’s really exciting,” said Tung, director of cardiac electrophysiology at UChicago Medicine. “Now we have shown for the first time in the United States that this could be a viable therapy for patients who haven’t responded to other treatments.”
A case report about the patient and the procedure was published June 10 in JACC Case Reports.
The woman initially came to Tung because she had suffered from what is called vasovagal syncope for most of her life. The condition causes people to faint when certain triggers, like the sight of blood, cause their heart rate and blood pressure to drop suddenly and reduce blood flow to the brain.
The woman had tried several therapies to treat the condition, including medications and a dual-chamber pacemaker, but nothing seemed to work. She had read about cardioneural ablation therapy and approached Tung to see if he and his team would consider the procedure.
Tung is an expert on cardiac ablation, a minimally invasive procedure in which a catheter is threaded into the heart and heat is used to destroy tissue to restore correct heart rhythms. But physicians in other countries had shown that using the same technique to target ganglionated plexi (GP), clusters of neurons in the heart, had provided relief to those suffering from vasovagal syncope.
Tung agreed to the procedure on a compassionate-need basis, as he had followed the evolving field through international publications. “We wanted to see if this was feasible as a treatment in desperate situations,” he said.
—Prof. Jacqueline Stewart
