Arrhythmias & electrophysiology
Cardioneuroablation for reflex asystolic syncope: Mid-term safety, efficacy, and patient’s acceptance
Authors' conclusion
Mid-term efficacy of CNA exceeds 80%, and acute complications are absent. The most frequent mid-term chronic complication is inappropriate sinus tachycardia, which in 7% required chronic treatment. The procedure is well accepted by patients.
Study context
- Population
- Patients with reflex asystolic syncope treated 2016–2022 with ≥1-year follow-up (mean age 39 ± 13 years; 58% female)
- Participants
- 115 consecutive patients
- Outcome
- Mid-term safety, efficacy (freedom from syncope) and patient acceptance of CNA
- Follow-up
- Median 28 months (range 12-75)
Methodological detailssingle-centre, consecutive patients
- Single-centre
- Consecutive patients
Main finding
As reported in the abstract
Freedom from syncope
Remained free from syncope after cardioneuroablation (CNA)
95
83%
Observational data: associations, not effects.
Further findings
| Outcome | Values |
|---|---|
| Repeated CNA / pacemaker implantationEvents/value = repeated CNA | CNA 3% · Pacemaker implantation 5 (4%) |
| Patient acceptanceStated that it was worth undergoing the procedure | CNA 96% |
Syncope burden in patients with recurrence (n = 20, 17%)
- Syncope burden decreased from mean 17 (median 6.5) to 3.75 (median 2.5) episodes
- P = 0.015
Pacing system removal
- Pacing system removal possible
- 9 of 10 patients
Safety
| Outcome | Values |
|---|---|
| Dyspnea, chronic chest pain, decreased exercise capacity (mild) | CNA 14% |
Sinus rhythm acceleration (heart rate)
- Heart rate from 60 ± 14 bpm to 90 ± 16 bpm
- P < 0.0001
- Symptomatic
- 31 patients (27%)
- Required chronic beta-blocker and/or ivabradine
- 8 patients (7%)
- Sinus node modification necessary
- 1 patient
Original publication
Cardioneuroablation for reflex asystolic syncope: Mid-term safety, efficacy, and patient’s acceptance. Heart Rhythm. Published 29 November 2023. doi:10.
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