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Recurrent Fainting Episodes Turned Out to be Heart-Related: Ablating the Vagus Nerve Provides Relief
A junior high school student experienced recurrent fainting episodes, initially diagnosed as seizures. They later sought medical advice from Dr. Lin Guohong, Chief of Cardiology at China Medical University Hsinchu Hospital. Dr. Lin diagnosed the student with vasovagal syncope, a condition in which overstimulation of the vagus nerve leads to a slow heart rate and a drop in blood pressure, causing fainting. The patient is currently managed with a pacemaker to prevent slow heart rates.
Dr. Lin explained that there is a treatment method gaining popularity overseas for vasovagal syncope, involving the ablation of the vagal nerve ganglia in the heart. By ablating these ganglia, it is possible to suppress the slowing of heart rate and dropping of blood pressure, effectively treating vasovagal syncope.
Vasovagal syncope is characterized by a sudden loss of consciousness due to a significant drop in heart rate and blood pressure. These fainting episodes can occur abruptly and without warning, posing a considerable risk, particularly when driving or in situations where falls can result in fractures and severe injuries.
In the past, pacemakers were used to address slow heart rates in these patients. However, if blood pressure drops were also present, pacemakers alone were not effective. Many of these patients are young, requiring pacemaker replacements every ten years or the use of medications to elevate blood pressure, both of which are considered conservative treatment approaches.
Approximately five years ago, a treatment method involving the ablation of vagal nerve ganglia on the heart's surface gained popularity overseas. By ablating these ganglia, it is possible to suppress the slowing of heart rate and dropping of blood pressure, leading to a cure for vasovagal syncope in over 90% of cases. This approach offers a one-time solution to the condition.
The vagal nerve ganglia are located on the heart's surface and are non-regenerative. By precisely locating these ganglia and using a method known as radiofrequency ablation, they can be destroyed, allowing heart rate and blood pressure to return to normal.