Efficacy of cardioneurablation for vasodepressor vasovagal syncope

Abstract

Objective Cardioneuroablation (CNA) is effective for cardiac inhibitory and mixed vasovagal syncope (VVS) but not vasodepressor VVS. This study aimed to assess the therapeutic benefits of CNA in vasodepressor VVS. Methods VVS patients hospitalized in the Department of Cardiology of Jiangxi Provincial People's Hospital were retrospectively reviewed. Holter monitoring was performed before, during, and 3 months after CNA. Changes in heart rate and Wenckebach point of atrioventricular conduction before and after ablation were compared. Results Thirty-five patients were enrolled, 18 men and 17 women. Mean age was 47.48 ± 16.49 years. Median duration of syncope was 24.0 months (range, 2.5–66.0). Median number of syncope episodes before treatment was two (range, 2–4). The time domain indexes of heart rate variability, mean heart rate, maximum heart rate, and minimum heart rate were significantly higher 3 months after CNA. Mean follow-up was 11 ± 4.67 months. Recurrent syncope occurred in two patients with vasodepressor VVS, one of them with presyncope symptoms in vasodepressor type; and one patient occurred with mixed VVS, without presyncope symptoms. No serious complications occurred. CNA is safe and effective in the treatment of vasodepressor VVS. Conclusions CNA is effective for treating vasodepressor VVS. Our study provides a theoretical basis for individualization of treatment in patients with vasodepressor VVS.