Frequent neurally mediated reflex syncope in a young patient with dextrocardia: Efficacy of catheter ablation of the superior vena cava-aorta ganglionated plexus.
Neurally mediated reflex syncope is the most common cause of syncope in young individuals without cardiac or neurological pathology. We report a case of successful catheter ablation in a 17-year-old male with neurally mediated syncope (NMS) of the cardioinhibitory type. The patient had dextrocardia situs inversus totalis with a mirror-image reversal of the thoracic and abdominal organs. Because he experienced multiple syncope episodes despite pharmacological intervention, we performed endocardial ablation of the superior vena cava-aorta ganglionated plexus. Shortly afterwards, his heart rate increased from 40 to 76 beats per minutes. He has not experienced syncope during the 1-year follow-up.
Division of Cardiology and Catheter Laboratories, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura City, Kanagawa 247-8533, Japan.
Hidetaka
H
Suenaga
Division of Cardiology and Catheter Laboratories, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura City, Kanagawa 247-8533, Japan.
Masato
M
Murakami
Division of Cardiology and Catheter Laboratories, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura City, Kanagawa 247-8533, Japan.
Tomoyuki
T
Tani
Division of Cardiology and Catheter Laboratories, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura City, Kanagawa 247-8533, Japan.
Shigeru
S
Saito
Endocardial ablation; Neurally mediated syncope; Superior vena cava