Arrhythmias & electrophysiology
Cardioneuroablation in patients with vasovagal syncope: An updated systematic review and meta-analysis
Authors' conclusion
This study supports the efficacy and safety of CNA in preventing syncope recurrence in patients with VVS. Furthermore, the electroanatomic mapping method of GP targeting and the right atrium approach were associated with a higher syncope recurrence rate than other methods.
Study context
- Population
- Patients with refractory vasovagal syncope (VVS); median age 39.6 years27 observational studies, 1 RCT
- Participants
- 1,153 patients
- Outcome
- Syncope recurrence
- Follow-up
- 21.4 months
Methodological detailsprespecified subgroup analyses
- Prespecified subgroup analyses
Pooled result
As reported in the abstract
Syncope recurrence after CNA (overall weighted rate)
Cardioneuroablation (CNA)
5.94%
95% CI 3.37%–9.01%
Further pooled results
| Outcome | Values |
|---|---|
| Syncope recurrence, electroanatomic mapping GP targeting (prespecified subgroup) | Electroanatomic mapping 6.21% (95% CI 2.93%–10.28%) |
| Syncope recurrence, right atrium approach (prespecified subgroup) | Right atrium approach 15.78% (95% CI 3.61%–33.14%) |
- Syncope recurrence, electroanatomic mapping ganglionated plexus (GP) targeting (prespecified subgroup): I2 = 0%
- Syncope recurrence, right atrium approach (prespecified subgroup): I2 = 65.2%
Syncope recurrence, electroanatomic mapping GP targeting (prespecified subgroup)
- Higher prevalence of syncope recurrence in electroanatomic mapping subgroup
Syncope recurrence, right atrium approach (prespecified subgroup)
- Higher prevalence of syncope recurrence with right atrium approach
Safety
| Outcome | Values |
|---|---|
| Periprocedural complications | CNA 0.99% (95% CI 0.14%–2.33%) |
- Periprocedural complications: I2 = 0%
Original publication
Cardioneuroablation in patients with vasovagal syncope: An updated systematic review and meta-analysis. Heart Rhythm. Published 25 July 2024. doi:10.
Summarised from the published abstract; every number is checked against it