Arrhythmias & electrophysiology
Intracardiac echocardiography guided anatomical approach to cardioneuroablation: feasibility and outcomes
Authors' conclusion
An ICE-guided anatomical approach to CNA targeting visible FPs at the Waterston's groove is a feasible and effective strategy to achieve SN/AVN vagal denervation, with good outcomes at mid-term follow-up.
Study context
- Population
- Patients undergoing cardioneuroablation (CNA) for recurrent vasovagal syncope with documented sinus pauses and/or AV block
- Participants
- 17 patients
- Outcome
- Feasibility of sinus node (SN)/atrioventricular node (AVN) vagal denervation: FP identification and acute vagal response
- Follow-up
- After ablation
Main finding
As reported in the abstract
Target fat pads (FPs) identified with ICE
all patients
>25% shortening of PP interval within first 1-2 RF lesions
all cases
Complete abolition of sinus pauses/AVN block (AVB) response with ECVS after ablation
all patients
Further findings
Freedom from recurrent symptoms · median follow-up 12 months (range 4-25 months)
- Free of recurrent symptoms
- 16 patients (94%)
- 1 repeat CNA for recurrent pre-syncope and AVB
- 1 PPM implant for asymptomatic diurnal AVB
Original publication
Intracardiac echocardiography guided anatomical approach to cardioneuroablation: feasibility and outcomes. Europace. Published 18 November 2025. doi:10.
Summarised from the published abstract; every number is checked against it