Cardioneuroablation for the treatment of vasovagal syncope, functional sinus node dysfunction and functional atrioventricular block: initial experience in one center

Abstract Funding Acknowledgements Type of funding sources: None. Background and purpose Cardioneuroablation (CNA) or ablation the ganglionated plexi (GP) is an emergent procedure that has been used in treatment vasovagal syncope (VVS), functional sinus node dysfunction (SND) atrioventricular block (AVB). The aim present study was to describe our initial experience with this technique. Methods Prospective, unicentric, observational consecutive patients which were referred institution for VVS, SND AVB. Prior procedure, all underwent atropine test. Results A total 19 included (51.5 ± 12.7 years, 68.4% males). 15 (78.9%) had prior a median 1.6 3.8 episodes per month. 8 (42.1%) due recurrent 6 (31.6%) 5 (26.3%) there increase 39 8% heart rate (HR) Extracardiac vagal stimulation, attempted 11 (59.7%) from them, only 63.6% responses. We anatomic approach 79% patients. right superior GP ablated bi-atrial 100% At end negative test HR significantly lower than (39 vs 5%; p=0.002). After follow-up 8.5 (3.9-17.7) months, freedom 93.3% incidence decrease 0.02 0.11 Freedom pacemaker implantation 88.8%. There significant reduction who presyncope after (94.7% 21.1%; p=0.002) (Figure 1). No complications observed related procedure. Conclusions In CNA could be reasonable option young AVB, even alternative implantation. However more prospective randomized studies are needed support these conclusions.