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June 13, 2025Arrhythmia & Electrophysiology ReviewOpen Access

Inappropriate Sinus Tachycardia Following Cardioneuroablation for Reflex Syncope: A Case Report and Review of the Literature Illustrating this Underappreciated Adverse Effect

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Why the study?

Because cardioneuroablation involves parasympathetic denervation, inappropriate sinus tachycardia may be an underappreciated potential adverse effect.

Does cardioneuroablation cause inappropriate sinus tachycardia in patients with reflex syncope?

Design

Case report and literature review

Key result

Cardioneuroablation for reflex syncope in an 18-year-old female resulted in intractable inappropriate sinus tachycardia, ultimately requiring sinus node modification and pacemaker implantation.

Authors

PKPiotr KułakowskiRPRoman Piotrowski

Discussion

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Overview

Warns of intractable IST after cardioneuroablation for reflex syncope; leaves open incidence and risk mitigation.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

Does cardioneuroablation cause inappropriate sinus tachycardia in patients with reflex syncope?

P
Population
1 patient with mixed vasovagal syncope and symptomatic sinus bradycardia
I
Intervention
Cardioneuroablation (CNA)
O
Outcome
Development of inappropriate sinus tachycardia (IST)safety

Cardioneuroablation for reflex syncope can lead to inappropriate sinus tachycardia as an adverse effect, potentially requiring pacemaker implantation.

Limitations

  • Post-CNA inappropriate sinus tachycardia is likely under-reported in the literature.
  • Terminology and definitions of post-CNA inappropriate sinus tachycardia vary broadly across studies.
  • There is no optimal follow-up scheme recommended for detecting this complication.
  • The long-term adverse effects and prognosis of persistent post-CNA inappropriate sinus tachycardia remain unknown.

Cite This Study

Kułakowski et al. (2025) conducted a case report in Reflex syncope and functional bradycardia (n=1). Cardioneuroablation (CNA) was evaluated. Cardioneuroablation for reflex syncope in an 18-year-old female resulted in intractable inappropriate sinus tachycardia, ultimately requiring sinus node modification and pacemaker implantation.

synapsesocial.com/papers/6a0c6bff93c2b42b5c8867dchttps://doi.org/10.15420/aer.2025.01
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