D’après l’étude : Feasibility, Safety, and Efficacy of Compassionate Cardioneuroablation for Functional Bradycardia and Reflex Syncope: Outcomes from the Multicenter US CNA Registry – Presented by Dr Roderick Tung.
Key messages
- This is the most important register published to date on cardioneuroablation
- One year after the cardioneuroablation procedure, almost 80 % of patients had not reoffended their syncope
- The complication rate was 5%
Introduction
Cardioneuroablation is a procedure whose aim is to carry out a vagal denervation in patients with symptoms and not wishing permanent cardiac stimulation.
Few results on cardioneuroablation procedures have been published until then.
Methodology and results
Design
This is a retrospective multicentric observational study that took place in 15 American centers.
Judgment criteria
Evaluate the feasibility, security and results of the cardioneuroablation carried out for indications of syncope of vagal origin.
Results
210 procedures in 205 patients were carried out.
On average 697 ± 1515 sec of radio frequency were delivered. The heart rate increased on average by 20 ± 15 bpm (from 58 ± 15 to 78 ± 15 bpm = and the AH interval has shortened from 99 ± 30 to 90 ± 32 ms.
Complications occurred in 4.7% of patients (hemopericarde n = 2; respiratory insufficiency n = 2; paralysis of the phrenic nerve n = 1; lesion of the sinus node n = 4, death n = 1).
-- Results secondary criteria
- Safety if therapeutic trial
Regarding the efficiency of the procedure, at 14 ± 11 months of removal, 78% of patients had not recurred on a syncopal episode and 97% were not established with a cardiac stimulator.
Conclusion
Even if the management in this study was heterogeneous and it did not include a control group, the cardioneuroablation showed its effectiveness in the management of syncope of vagal origin.
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References
Tung R, Pujol-Lopez M, Locke A H, Alyesh D M, Sundaram S, Shah A D , et al. Cardioneuroablation for functional bradycardia and vasovagal syncope outcomes from the us multicenter cna registry, JACC: Clinical Electrophysiology, 2025.
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