Arrhythmias & electrophysiologyCohort study
Physiological Markers of Effective Autonomic Denervation Are Associated With Outcomes After Cardioneuroablation for Vasovagal Syncope
- retrospective cohort
Authors' conclusion
There is a substantial rate of recurrent syncope after CNA with intermediate-term follow-up. Inadequate acute procedural endpoints may be associated with recurrence.
Study context
- Population
- Patients who underwent cardioneuroablation (CNA) for vasovagal syncope refractory to lifestyle modification with at least 1 year of follow-uppatients meeting inclusion criteria
- Participants
- 57 patients
- Exposure
- Clinical and procedural characteristics analyzed for association with recurrence of syncope
- Recurrent syncopen = 25
Main finding
As reported in the abstract
Patients with recurrent syncope
25 patients (44%)
Observational data: associations, not effects.
Further findings
Vagal response during ablation of the left-sided ganglionated plexus · more likely in patients free from recurrence
P = 0.001
Positive atropine response at the end of the procedure · less likely in patients free from recurrence
P = 0.04
Increase in sinus rate during the ablation · greater increase in patients free from recurrence
P = 0.01
Recurrent syncope by number of favorable physiological markers
- Recurrence rate in patients meeting all 3 criteria (lowest)
- 14%
- Progressively lower rates of recurrent syncope with a greater number of favorable markers
Safety
Symptomatic inappropriate sinus tachycardia
- Overall
- 14%
- After CNA guided by extracardiac vagal stimulation vs not
- 64% vs 2%
- more common after CNA guided by extracardiac vagal stimulation
Original publication
Summarised from the published abstract; every number is checked against it