Carotid sinus syndrome treated by cardioneuroablation: Is sinus node denervation enough? Insights from a syncope recurrence report

Cardioneuroablation for carotid sinus syndrome mediated by complete atrioventricular block

“…Due to the similar efferent mechanism of the cardioinhibitory CSS mediated by vagal nerve, potential therapeutic effect of vagal denervation may be hypothesized. Indeed, there are rare case reports of cardioneuroablation in this condition 3–5 . We have performed biatrial cardioneuroablation in contrast to Palama et al, aiming for durable lesions and potentially less vagal reinnervation which was observed and reported by Zerpa Acosta et al 3,5 …”

“…Indeed, there are rare case reports of cardioneuroablation in this condition. [3][4][5] We have performed biatrial cardioneuroablation in contrast to Palama et al, aiming for durable lesions and potentially less vagal reinnervation which was observed and reported by Zerpa Acosta et al 3,5 Optimal technique of cardioneuroablation in this patient population is unknown. In all previously mentioned reports, sinus bradycardia and arrest were the dominant clinical presentations; therefore, cardioneuroablation targeting both the sinus node and the atrioventricular node was performed.…”

“…Indeed, there are rare case reports of cardioneuroablation in this condition. 3 , 4 , 5 We have performed biatrial cardioneuroablation in contrast to Palama et al, aiming for durable lesions and potentially less vagal reinnervation which was observed and reported by Zerpa Acosta et al 3 , 5 …”

“…In all previously mentioned reports, sinus bradycardia and arrest were the dominant clinical presentations; therefore, cardioneuroablation targeting both the sinus node and the atrioventricular node was performed. 3 , 4 , 5 Although we have also targeted all efferent input into both nodes, whether targeting atrioventricular efferent input only would suffice remains to be elucidated.…”