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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Cardiac Rhythmology
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1526825

Cardioneuroablation for reflex syncope or functional bradyarrhytmias: new insight from a single center experience

Provisionally accepted
NOEMI VALENTI NOEMI VALENTI 1Antonio Di Monaco Antonio Di Monaco 1*Imma Romanazzi Imma Romanazzi 2Nicola Vitulano Nicola Vitulano 1Federica Troisi Federica Troisi 1Federico Quadrini Federico Quadrini 1Rosa Caruso Rosa Caruso 1Vincenzo Anzelmo Vincenzo Anzelmo 1Pietro Guida Pietro Guida 1Massimo Grimaldi Massimo Grimaldi 1
  • 1 Ospedale Generale Regionale F. Miulli, Acquaviva, Italy
  • 2 Department of Cardiology, Hospital “San Paolo”, Bari, Italy, BARI, Italy

The final, formatted version of the article will be published soon.

    Background: Cardioneuroablation (CNA) is a new approach to treat reflex syncope and functional bradyarrhytmias caused by autonomic imbalance. We report our experience using CNA.Method: From September 2022 to July 2023, we took care of 21 patients (mean age 42±21 years; 62% male) affected by reflex syncope or functional bradyarrhythmias. All patients underwent CNA under conscious sedation targeting the superior and/or inferior paraseptal ganglionated plexus (GPs).Results: Nine patients were affected by vasovagal syncope (VVS) and twelve by functional bradyarrhythmias. In 3 cases (14%) the ablation was performed only on the GPs of the right atrium, while in the remaining 86% of cases we performed biatrial lesions. As regards the acute results, we highlighted an increase in sinus heart rate (12±15 bpm, p = 0.001), a shortening of the PQ interval (-18±18 msec, p < 0.001), a reduction of the correct sinus node recovery times (cSNRT) (-142±204 msec, p = 0.114), a shortening of the AH interval (-31±26 msec, p = 0.008), a reduction of the effective refractory period of the atrio-ventricular node (-156; interquartile range from -30 to -160 msec, p = 0.042) and an increase in the Wencheback point (27±20 bpm, p < 0.001). At follow-up, a single patient, due to persistent symptoms and bradyarrhythmic disorder, underwent permanent pacemaker implantation; no other patient had recurrence of syncope, and all remained persistently asymptomatic.Our results confirm the efficacy and safety of CNA for the treatment of VVS and functional bradyarrhythmias, although further studies are needed to support these findings.

    Keywords: Reflex syncope, Bradycardia, atrio-ventricular block, Cardioneuroablation, Neuromodulation, Catheter Ablation

    Received: 12 Nov 2024; Accepted: 24 Dec 2024.

    Copyright: © 2024 VALENTI, Di Monaco, Romanazzi, Vitulano, Troisi, Quadrini, Caruso, Anzelmo, Guida and Grimaldi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Antonio Di Monaco, Ospedale Generale Regionale F. Miulli, Acquaviva, 70021, Italy

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