Key result
Zero-fluoroscopy biatrial cardioneuroablation eliminates swallowing-induced syncope and AV block at 3 months.
Why the study?
Does zero-fluoroscopy biatrial cardioneuroablation prevent recurrent syncope and high-degree atrioventricular block in a patient with refractory swallowing-induced syncope?
Case Report (n=1)
No
Does zero-fluoroscopy biatrial cardioneuroablation prevent recurrent syncope and high-degree atrioventricular block in a patient with refractory swallowing-induced syncope?
This case demonstrates that zero-fluoroscopy biatrial cardioneuroablation can successfully abolish functional high-degree AV block and recurrent syncope in swallowing-induced syncope, serving as a viable alternative to permanent pacemaker implantation.
Answers are grounded in this paper and cite their sources.
May support cardioneuroablation as a pacing alternative in refractory cases; hypothesis-generating and should not yet change practice.
Key Teaching Points•Cardioneuroablation can be considered as an alternative to pacing in selected patients with swallow syncope that are refractory to conservative management.•The sites and extent of ablation depend on the type of cardioinhibitory response (asystole vs atrioventricular block), although a complete vagal denervation involving both atria probably offers the best chances of clinical success.•Zero-fluoroscopy is a feasible approach for cardioneuroablation that minimizes the effects of radiation exposure for patients and health care staff. •Cardioneuroablation can be considered as an alternative to pacing in selected patients with swallow syncope that are refractory to conservative management.•The sites and extent of ablation depend on the type of cardioinhibitory response (asystole vs atrioventricular block), although a complete vagal denervation involving both atria probably offers the best chances of clinical success.•Zero-fluoroscopy is a feasible approach for cardioneuroablation that minimizes the effects of radiation exposure for patients and health care staff.
No takes yet. Share an insight, caveat, or question.
Miranda‐Arboleda et al. (2023) conducted a case report in Swallowing-induced syncope with high-degree atrioventricular block (n=1). Zero-fluoroscopy biatrial cardioneuroablation (CNA) was evaluated on Recurrence of syncope or atrioventricular block at 3-month follow-up. Zero-fluoroscopy biatrial cardioneuroablation eliminated swallowing-induced syncope and high-degree AV block at 3-month follow-up, increasing resting heart rate from 44 to 88 bpm.
Synapse has enriched 10 related papers. Consider them for comparative context: