Key result
Cardioneuroablation for reflex syncope linked to intractable IST requiring sinus node modification and pacemaker.
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?
Case Report (n=1)
No
Does cardioneuroablation cause inappropriate sinus tachycardia in patients with reflex syncope?
Cardioneuroablation for reflex syncope can lead to inappropriate sinus tachycardia as an adverse effect, potentially requiring pacemaker implantation.
Answers are grounded in this paper and cite their sources.
Warns of intractable IST after cardioneuroablation for reflex syncope; leaves open incidence and risk mitigation.
Inappropriate sinus tachycardia (IST) is a clinical syndrome that generally affects young patients and is associated with distressing symptoms. Cardioneuroablation (CNA) is a promising method for the treatment of asystolic reflex syncope, functional bradycardia or atrioventricular block. Because CNA involves parasympathetic denervation, one potential adverse effect may be IST. We present an educational case of a patient with mixed vasovagal syncope and symptomatic sinus bradycardia who underwent CNA, as a result of which bradycardia converted to IST and the patient required subsequent pacemaker implantation. We also review the incidence of IST after CNA and difficulties around the definition and treatment of post-CNA IST.
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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.
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