Invasive management of sinus tachycardia in severe cardiovascular dysautonomia: preliminary observations from POL-CA (POLish Registry of CArdioneuroablation and CArdioneuromodulation)

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Severe cardiovascular dysautonomia (Inappropriate Sinus Tachycardia / Postural Orthostatic Tachycardia Syndrome) (n=60). Intervention: Phenotype-oriented invasive cardioneuromodulation (primarily sinus node sparing hybrid ablation). Primary outcome: Clinically significant improvement (composite of MAPS-PL score <42, lower heart rate, improved orthostatic tolerance and exercise capacity, and partial reduction of medications).

M Kornaszewska; Natalia Ogorzelec; Mariusz Kowalewski; Artur Fedorowski; Piotr Suwalski; Sebastian Stec

doi:10.20452/pamw.17400

September 18, 2026Polskie Archiwum Medycyny WewnętrznejOpen Access

Invasive management of sinus tachycardia in severe cardiovascular dysautonomia: preliminary observations from POL-CA (POLish Registry of CArdioneuroablation and CArdioneuromodulation)

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Study Design

Type

Observational (n=60)

Multicenter

Yes

PICO

P

Population

60 predominantly female patients (median age 29) with severe, drug-refractory inappropriate sinus tachycardia or postural orthostatic tachycardia syndrome referred for invasive evaluation, followed for 1 year.

I

Intervention / Comparator

Phenotype-oriented invasive cardioneuromodulation (primarily sinus node sparing hybrid ablation)

O

Primary Outcome

Clinically significant improvement (composite of MAPS-PL score <42, lower heart rate, improved orthostatic tolerance and exercise capacity, and partial reduction of medications)

Limitations

Observational registry design from highly specialized referral centers
Limited sample size
Standardized objective endpoints were not consistently available in all patients
Invasive treatment selection was largely dependent on multidisciplinary clinical judgment rather than validated phenotype-driven algorithms

Implication

Registry study demonstrates symptomatic improvement in severe cardiovascular dysautonomia, suggesting tailored invasive procedures relieve drug-refractory sinus tachycardia.

Abstract

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Discussion

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Cite This Study

Kornaszewska et al. (2026) conducted an observational in Severe cardiovascular dysautonomia (Inappropriate Sinus Tachycardia / Postural Orthostatic Tachycardia Syndrome) (n=60). Phenotype-oriented invasive cardioneuromodulation (primarily sinus node sparing hybrid ablation) was evaluated on Clinically significant improvement (composite of MAPS-PL score <42, lower heart rate, improved orthostatic tolerance and exercise capacity, and partial reduction of medications).

synapsesocial.com/papers/6aae492d0c69660b71ecc6fd https://doi.org/10.20452/pamw.17400

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Invasive management of sinus tachycardia in severe cardiovascular dysautonomia: preliminary observations from POL-CA (POLish Registry of CArdioneuroablation and CArdioneuromodulation)

Study Design

PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

Invasive management of sinus tachycardia in severe cardiovascular dysautonomia: preliminary observations from POL-CA (POLish Registry of CArdioneuroablation and CArdioneuromodulation)

Study Design

PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

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