Cardioneuroablation in the Management of Vasovagal Syncope, Sinus Node Dysfunction and Functional Atrioventricular Block: Patient Selection Based on Supporting Evidence.

The problem with the regulation of the autonomic nervous system or paroxysmal reflex vagal activation episodes may have an important role in the pathophysiology of vasovagal syncope (VVS), sinus bradycardia or periods of sinus arrest, and variable-degree atrioventricular block (AVB). Because existence of structural heart disease tends to shift the vagosympathetic balance towards a sympathetic predominance, vagally-mediated bradyarrhythmias (VMB) usually occurs in young individuals with structurally normal hearts. However, similar reflex problems may be observed in the elderly people and even those with structural heart disease.

Utility of Head up Tilt Table Testing to Demonstrate Selective Denervation of the Sinus Node after Cardioneuroablation.

A 65-year-old female who underwent cardioneuroablation for recurrent vasovagal syncope presented for 6 month follow-up visit. She had no further syncope after the procedure. A follow up tilt table testing (TT) demonstrated sinus tachycardia and variable degrees of atrioventricular block (AVB) after sublingual glyceryl trinitrate.

Percutaneous renal sympathetic denervation in catecholaminergic polymorphic ventricular tachycardia.

Catheter-based renal sympathetic denervation may be an alternative after unsuccessful conventional ablation attempts.

A late form of neurosyphilis manifesting with psychotic symptoms in old age and good response to ceftriaxone therapy.

Neurosyphilis can present with psychiatric symptoms. The late form can occur in old age with psychosis, paranoid delusions, affective disorders or cognitive impairment. Here we present a case of neurosyphilis in an elderly woman who, over six months, progressively manifested personality changes and paranoid delusions which were initially suspected as Alzheimer's disease.

[Thrombi in the right atrium and inferior vena cava mimicking myxoma in a patient with recurrent pulmonary thromboembolism].

A 26-year-old male patient presented with complaints of pain, dyspnea, and hemoptysis of one-week history, while on oral anticoagulation treatment that had been started two years before upon the diagnosis of pulmonary thromboembolism. Transthoracic echocardiography showed two mass lesions in the right atrium and inferior vena cava, measuring 3.5x3 cm and 1.