Key result
Cardioneuroablation yields no syncope recurrence at 12 months in a cardioinhibitory vasovagal patient.
Why the study?
Cardioneuroablation has emerged as an alternative to pacing for vasovagal syncope, but the lack of a universally accepted protocol tailored for patient selection presents a gap in guidelines.
Does cardioneuroablation prevent recurrence of syncopal episodes in a patient with cardioinhibitory vasovagal syncope?
Case Report (n=1)
Does cardioneuroablation prevent recurrence of syncopal episodes in a patient with cardioinhibitory vasovagal syncope?
Cardioneuroablation guided by tilt-table testing with Russo's Fast Italian Protocol successfully prevented syncope recurrence at 12 months in a patient with cardioinhibitory vasovagal syncope.
Cardioneuroablation may be considered in refractory cardioinhibitory vasovagal syncope; hypothesis-generating and requires randomized confirmation before practice change.
Background: Cardioneuroablation (CNA) has emerged as a promising therapeutic alternative to conventional pacing therapy for vasovagal syncope (VVS). Accurate patient selection and diagnosis are crucial for achieving optimal outcomes. The lack of a universally accepted protocol specifically tailored for selecting patients for CNA presents a gap in the current guidelines. Case summary: revealed a cardioinhibitory vasovagal response, traditionally managed with pacemaker therapy. The patient, however, opted for CNA. Targeted radiofrequency ablation of the ganglionated plexi in the right and left atria was successfully performed. Clinical follow-up at 12 months post-ablation revealed no recurrence of syncopal episodes. Discussion: This case highlights the utility of tilt testing and the efficacy of the FIP as an efficient diagnostic tool for evaluating cardioinhibitory vagal responses. It supports its role in patient selection for CNA and additionally presents a promising option for a non-invasive follow-up assessment, though further investigation is needed. Its simplicity and efficiency position it as a promising candidate for standardization as the primary diagnostic tool in CNA workflows.
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Stangl et al. (2025) conducted a case report in Vasovagal syncope (n=1). Cardioneuroablation was evaluated on Recurrence of syncopal episodes. Cardioneuroablation of the ganglionated plexi resulted in no recurrence of syncopal episodes at 12 months post-ablation in a patient with a cardioinhibitory vasovagal response.
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