Cardioneuroablation for reflex asystolic syncope: Mid-term safety, efficacy, and patient’s acceptance

Kulakowski, Piotr; Baran, Jakub; Sikorska, Agnieszka; Krynski, Tomasz; Niedzwiedz, Michal; Soszynska, Malgorzata; Piotrowski, Roman

doi:10.1016/j.hrthm.2023.11.022

Cited by 9 publications

(1 citation statement)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a recently published study including 115 patients with vasovagal syncope, intracardiac echocardiography was used to identify important anatomical landmarks and epicardial fat pads with presumed GP areas. 11 Computed tomography–guided epicardial adipose tissue was also used in identifying GPs that were verified by high-frequency stimulation. 18 In the present study, these two imaging methods were used in addition to electrogram analysis based on operator discretion.…”

Section: Discussionmentioning

confidence: 99%

Procedural and Intermediate-term Results of the Electroanatomical-guided Cardioneuroablation for the Treatment of Supra-Hisian Second- or Advanced-degree Atrioventricular Block: the PIRECNA multicentre registry

Aksu,

Piotrowski,

Tung

et al. 2024

Europace

Self Cite

View full text Add to dashboard Cite

Aims Prior case series showed promising results for cardioneuroablation in patients with vagally induced atrioventricular blocks (VAVBs). We aimed to examine the acute procedural characteristics and intermediate-term outcomes of electroanatomical-guided cardioneuroablation (EACNA) in patients with VAVB. Methods and results This international multicentre retrospective registry included data collected from 20 centres. Patients presenting with symptomatic paroxysmal or persistent VAVB were included in the study. All patients underwent EACNA. Procedural success was defined by the acute reversal of atrioventricular blocks (AVBs) and complete abolition of atropine response. The primary outcome was occurrence of syncope and daytime second- or advanced-degree AVB on serial prolonged electrocardiogram monitoring during follow-up. A total of 130 patients underwent EACNA. Acute procedural success was achieved in 96.2% of the cases. During a median follow-up of 300 days (150, 496), the primary outcome occurred in 17/125 (14%) cases with acute procedural success (recurrence of AVB in 9 and new syncope in 8 cases). Operator experience and use of extracardiac vagal stimulation were similar for patients with and without primary outcomes. A history of atrial fibrillation, hypertension, and coronary artery disease was associated with a higher primary outcome occurrence. Only four patients with primary outcome required pacemaker placement during follow-up. Conclusion This is the largest multicentre study demonstrating the feasibility of EACNA with encouraging intermediate-term outcomes in selected patients with VAVB. Studies investigating the effect on burden of daytime symptoms caused by the AVB are required to confirm these findings.

show abstract

Section: Discussionmentioning

confidence: 99%