Cardioneuroablation in ictal asystole—New treatment method

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Cardioneuroablation in ictal asystole—New treatment method Bor Antolic, MD, PhD, Veronika Rutar Gorisek, MD, PhD, Gal Granda, MD, Bogdan Lorber, MD, MSc, Matjaz Sinkovec, MD, PhD, David Zizek, MD, PhD HeartRhythm Case Reports Volume 4, Issue 11, Pages 523-526 (November 2018) DOI: 10.1016/j.hrcr.2018.07.018 Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 1 Electroencephalography (EEG) and electrocardiography (ECG) changes occurring 35 seconds after the start of the seizure before and after cardioneuroablation procedure. A: Before the procedure, single-channel ECG demonstrated sinus rhythm slowing followed by asystole (23 seconds) and then a slow return to normal sinus rhythm. In postictal EEG with slow activity over the right hemisphere, the cerebral hypoperfusion resulted in generalized slow activity, followed by a “flat” EEG (22 seconds) and then generalized slow activity. B: After the procedure, single-channel ECG demonstrated normal sinus rhythm. In EEG, postictal slow activity over the right hemisphere abruptly returned to normal background activity. HeartRhythm Case Reports 2018 4, 523-526DOI: (10.1016/j.hrcr.2018.07.018) Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 2 A posterolateral view of 3-dimensional constructed virtual anatomy of the left and right atrium. Red dots designate radiofrequency ablation lesions on the interatrial septum. Violet dots show the phrenic nerve course. LA = left atrium; LIPV = left inferior pulmonary vein; RA = right atrium; RIPV = right inferior pulmonary vein; RSPV = right superior pulmonary vein; SVC = superior vena cava. HeartRhythm Case Reports 2018 4, 523-526DOI: (10.1016/j.hrcr.2018.07.018) Copyright © 2018 Heart Rhythm Society Terms and Conditions