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Letter to the Editor
© 2023 HMP Global. All Rights Reserved.
Any views and opinions expressed are those of the author(s) and/or participants and do not necessarily reflect the views, policy, or position of EP Lab Digest or HMP Global, their employees, and affiliates.
EP LAB DIGEST. 2023;23(7):17.
Dear Dr Knight,
I am JC Pachón-M, an electrophysiologist for 43 years, and I would like to congratulate you on your excellent work and service to the entire global electrophysiology community through EP Lab Digest. It is an extremely useful tool that provides constant updates in an objective and practical way that is indispensable for specialists.
I would also like to congratulate you on your excellent article “Letter From the Editor: Milestones in Cardiac Electrophysiology in the Past 25 Years,” from May 2023 (https://tinyurl.com/ffu8ps4m).
It is a fantastic panoramic view of electrophysiology in recent years in an extremely practical way, showing successful techniques and others that have been surpassed. The summary table is impressive, and I would like for it to become a section with scheduled updates!
We are very grateful to EP Lab Digest, because in 2019, they invited me to write one of the most influential and widely read articles on this topic: “Cardioneuroablation: Cardiac RF Catheter Vagal Denervation – Concept, Method, and Results” (https://tinyurl.com/2cn7673z), by José Carlos Pachón-M, et al, São Paulo University, São Paulo Dante Pazzanese Institute of Cardiology, São Paulo, Brazil, and Vrije Universiteit Brussel, Brussels, Belgium. In this way, we can only thank and congratulate the editor and all those who made this a reality!
As a contribution, I would like to suggest, if possible, for the next edition of “Milestones in Cardiac Electrophysiology in the Past 25 Years” for Cardioneuroablation to be moved to 2005, as even being created in the 1990s. In 2005, we had our first publication showing the results of the first trial, and we also received the US Patent for the name Cardioneuroablation and of the method (US-8216228-B2, Jose Carlos Pachon Mateos and Enrique Indalecio Pachon Mateos).
In 2015, we also developed another helpful tool for controlling vagal denervation called extracardiac vagal stimulation (Figure 1). Fortunately, it is for us another milestone as it makes any EP study/ablation of supraventricular tachycardia extremely easy and makes it possible to have objective control of the Cardioneuroablation and the atrial fibrillation (AF) ablation. This will make reliable a great number of future Cardioneuroablation studies in different services, providing an objective way of denervation comparison in the real world.
Figure reprinted with permission from EP Lab Digest. 2019;19(8):1,12-17.
Additionally, I am sharing the first presentation of Cardioneuroablation from Heart Rhythm 2005 (Figure 2). At that time, there was an explosion of studies on AF ablation, resynchronizers, and ICDs, so there was little space in the media to promote Cardioneuroablation, which is why it is easier to appear now.
Presented at Heart Rhythm 2005 and abstract published in Heart Rhythm. 2005;2(5):S64. doi:10.1016/j.hrthm.2005.02.204
At the recent Heart Rhythm 2023, we were invited to present what we consider a great application of Cardioneuroablation, which is denervation during AF ablation. Our Kaplan-Meier curves show that Cardioneuroablation can reduce AF recurrence more than 5 times in the chronic phase of AF RF ablation. It will be published soon.
Once again, I want to congratulate you on your publication as well as everyone who produces EP Lab Digest.
My kindest regards!
JC Pachón-M, MD, PhD, FHRS, CCDS, FLAHRS
