Key result
Cardioneuroablation avoids permanent pacemakers in two pediatric patients with functional bradycardia.
Why the study?
A highly symptomatic subgroup of pediatric patients with functional sinus node dysfunction and AV block may require definitive intervention beyond conservative measures, but permanent pacemaker implantation carries significant risks in this population.
Case Report (n=2)
Cardioneuroablation is presented as a potential intervention for pediatric patients with functional bradycardia to avoid the significant lifetime risks associated with permanent pacemaker implantation.
CNA may avert pacemaker implantation in select symptomatic pediatric cases; leaves open durability and generalizability pending larger studies.
Functional sinus node dysfunction and atrioventricular (AV) block in children and adolescents can stem from excessive parasympathetic activation.1 Although most patients respond to conservative measures, such as lifestyle modifications or pharmacotherapy, there is a highly symptomatic subgroup that may ultimately require a more definitive intervention.1,2 Although permanent pacemaker implantation effectively prevents asystolic events and hemodynamic compromise, it involves significant risks in the pediatric population, including infection, thrombosis, lead fracture, and repeated generator replacements over the patient’s lifetime.
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Solís-Gómez et al. (2025) conducted a case report in Functional bradycardia (n=2). Cardioneuroablation was evaluated. Cardioneuroablation was utilized in two pediatric patients with functional bradycardia as a definitive intervention to avoid the risks of permanent pacemaker implantation.
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