Arrhythmias & electrophysiology
A tailored approach to cardioneuroablation for reflex syncope and functional bradycardia: results from the ELEGANCE multicentre study
Authors' conclusion
An individualized CNA strategy, simplified by targeting specific GPs according to patient's pathophysiology, achieved outcomes equivalent to the standard approach while improving procedural efficiency through reduced RF delivery, shorter procedure duration, and limited ablation extent.
Study context
- Population
- Patients with reflex syncope and functional bradycardia undergoing cardioneuroablation73 men
- Participants
- 123 patients
- Exposure
- Tailored vs standard cardioneuroablation
- Tailoredn = 54
- Standardn = 69reference
- Outcome
- Procedural data
Methodological detailsmulticentre, European
- Multicentre
- European
Main finding
As reported in the abstract
Acute procedural success
P = 0.98
| Outcome | Tailored | Standard | P value | |
|---|---|---|---|---|
| Procedure time | 63 min | 85 min | P = 0.005 | |
| RF time | 5.4 min | 10.4 min | P < 0.001 | |
| Heart rate increase | 40 ± 30.7% | 40 ± 31.4% | P = 0.96 | |
| GPs targeted per patient | 1.6 ± 0.7 | Not reported in the abstract | Standard: not reported in the abstract |
Observational data: associations, not effects.
Further findings
Syncope recurrence · median 15.9 months [IQR: 9.8, 24.6] follow-up
- No differences in syncope recurrence rate
- log-rank P = 0.96
Safety
Inappropriate sinus tachycardia
P = 0.79
- Inappropriate sinus tachycardia — Overall
- 8.1%
Original publication
A tailored approach to cardioneuroablation for reflex syncope and functional bradycardia: results from the ELEGANCE multicentre study. Europace. Published 30 December 2025. doi:10.
Summarised from the published abstract; every number is checked against it