Methods
A total of 8 patients (1M/7FM, 33.4+12.8 years) with normal left ventricular systolic function (Ejection fraction %60.6+5%) were included. Patients were classified with VASIS classification. All patients had at least 3 episodes of syncope (8.7+3.4). Intracardiac electrocariograms were recorded 30-500 Hz with a sweep speed of 150-400 mm/s. Atrial mapping was performed via Ensite Velocity electronatomical mapping system. The sites showing fragmented potentials were identified by electrical mapping and verified by high-frequency stimulation and ablated until atrial electrical potential was completely eliminated (<0.1 mV) (Figure 1). The follow-up consisted of clinical evaluation, ECG (1 month/every 3 months/or symptoms), Holter (every 6 months/or symptoms), Head up Tilt Table test (1 month/every 3 months), and atropin test (end of ablation and ≥6 months). Clinical occurence of syncope and negative tilt table tests were defined as clinical end point.
Methods
A total of 8 patients (1M/7FM, 33.4+12.8 years) with normal left ventricular systolic function (Ejection fraction %60.6+5%) were included. Patients were classified with VASIS classification. All patients had at least 3 episodes of syncope (8.7+3.4). Intracardiac electrocariograms were recorded 30-500 Hz with a sweep speed of 150-400 mm/s. Atrial mapping was performed via Ensite Velocity electronatomical mapping system. The sites showing fragmented potentials were identified by electrical mapping and verified by high-frequency stimulation and ablated until atrial electrical potential was completely eliminated (<0.1 mV) (Figure 1). The follow-up consisted of clinical evaluation, ECG (1 month/every 3 months/or symptoms), Holter (every 6 months/or symptoms), Head up Tilt Table test (1 month/every 3 months), and atropin test (end of ablation and ≥6 months). Clinical occurence of syncope and negative tilt table tests were defined as clinical end point.
Results
The mean number of treated endocardial points was 36.8 ± 4.7. The mean procedure and the mean fluoroscopy time were 121.2 ± 16.4 minutes and 32.5 ± 6.8 minutes, respectively. Based on tilt table results, 6 of the patients had VASIS type 2B and 2 of the patients had VASIS type 1 response with a >3 sceond asystole. In all patients ablation were performed succesfully. After intervention, 2 patients with VASIS type 1 syncope had hypotensive response response during tilt table but did not have a asystole or bradycardia (Table 1). These patients had presyncopal complaints but did not have syncope during tilt table. One patient had symptoms of EHRA class 1 palpitation at 11th month.The average heart rate in the holter was 96/min. The patients were prescribed 50 mg metoprolol daily and diagnosed inapporiate sinus tachycardia. The patients complaints improved after drug treatment.
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