血管迷走性晕厥手术治疗的现状与展望

Current Status and Prospect of Non-surgical Treatment of Vasovagal Syncope

血管迷走性晕厥作为晕厥中最常见的一种形式,心脏抑制型晕厥患者经随机临床试验证实有效的药物疗法有限,可建议使用永久性起搏器治疗。本文梳理了起搏器治疗血管迷走性晕厥中曲折发展经历并总结了原因,根据指南整理了目前适用于起搏治疗的患者类型以及应用的局限性,心脏神经消融术可能成为血管迷走性晕厥患者的另一种选择,但尚需要大样本随机对照试验证实其安全性、有效性以及适用人群。

Vasovagal syncope is one of the most common forms of syncope.There are limited drug therapy options for patients with cardiosuppressive syncope,and permanent pacemaker therapy is recommended.This article reviews the tortuous development of pacemaker implication in the treatment of vasovagal syncope and summarizes the underlying reasons,and potential patients,who might benefit from pacing therapy and the limitations of its application according to the current guidelines.In the future,cardioneuroablation might become a therapeutic choice for patients with vasovagal syncope,the safety,efficacy and suitable patinets groups need to be validated in coming large sample randomized controlled clinical trials.