GuidelineEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2024
Cardioneuroablation for the treatment of reflex syncope and functional bradyarrhythmias: A Scientific Statement of the European Heart Rhythm Association (EHRA) of the ESC, the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS) and the Latin American Heart Rhythm Society (LAHRS).
Erratum issued 2 registry-linked trialsAbstract readReviewPractice Guideline
In one paragraph
Guideline in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 2 registered trials, which are not on this map. Cited by 62 papers, 1 of them a synthesis that pooled it.
0numbers the graph read from it
0cells of the map it votes in
62citing papers in PubMed, 1 pooled it
–field-weighted citation impact
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Comparative Study of Right Atrial Versus Bi-atrial Cardioneuroablation of Asystolic Reflex Syncope Verified by Implantable Loop Recorder
POL-CA Registry: Multicenter Observational Study of Neuromodulatory Procedures in Cardiovascular Autonomic Dysfunction Syndromes
Who cites it
62 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Peri-procedure and Mid-Long Term Effects of Pulsed Field Ablation vs. Thermal Ablation (Cryo- or Radiofrequency) on Autonomic Nervous System Function in Atrial Fibrillation: A Systematic and Quantitative Pooled-Analysis with Potential Implications for Patient Selection (The PULSE-COLD-HEAT-ANS Collaboration).Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Pooled it
- Recurrent vasovagal syncope treated with 2 sequential cardioneuroablation procedures.HeartRhythm case reports · 2026Article
- When 95% Atrial Pacing Does Not Mean Pacemaker Dependency.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Management of Syncope in Geriatric Patients: Are 2018 European Society of Cardiology Guidelines Still Relevant?Journal of clinical medicine · 2026Review
- Cardioneuroablation for Reflex Syncope and Functional Bradyarrhythmias: A State-of-the-Art Review.Journal of clinical medicine · 2026Review
- Profound vagal hyperreactivity unmasked after pacemaker implantation: a rare indication for cardioneuroablation-a case report.European heart journal. Case reports · 2026Article
- Fractionated Atrial Electrograms Identify Sites of Autonomic Responses During Pulmonary Vein Isolation: Insights for Cardioneuroablation.Journal of arrhythmia · 2026Article
- Cardioneuroablation versus cardiac pacemaker in the management of dominant cardioinhibitory vasovagal syncope: a retrospective cohort study.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Ice-cold beer-triggered swallow syncope with reproducible supra-Hisian AV block documented by intracardiac recordings.American heart journal plus : cardiology research and practice · 2026Article
- Zero-fluoroscopy cardioneuroablation in a pregnant woman with cardioinhibitory neurally mediated syncope.HeartRhythm case reports · 2026Article
- Transient Reflex Tachycardia After Cardioneuroablation for Vasovagal Syncope in an Endurance Athlete.JACC. Case reports · 2026Article
- Cardioneuroablation and substrate ablation for postsurgical atrial flutter and sinus node dysfunction in a pediatric patient.HeartRhythm case reports · 2026Article
- Genetic variant spectrum in patients with reflex syncope and vagally mediated atrioventricular block undergoing cardioneuroablation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Sensor detection and pacing for impending reflex syncope.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Review
- Empirical Anatomical Versus HAFE-Guided Cardioneuroablation for Vasovagal Syncope: Long-Term Efficacy and Safety Outcomes.Clinical cardiology · 2026Article
- Association Between Cardiac Acceleration Capacity and Susceptibility to Vasovagal Syncope: Autonomic Dysregulation in Vasovagal Syncope.JACC. Asia · 2026Article
- Cardioneuroablation: A Comprehensive Review.Reviews in cardiovascular medicine · 2026Review
- Enhanced mapping and targeting of ganglionated plexi using peak frequency analysis in cardioneuroablation: a study in autonomic cardiac disorders.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Efficacy and safety of cardioneuroablation as a treatment for patients with functional bradyarrhythmia: a systematic review and meta-analysis.International journal of cardiology. Heart & vasculature · 2026Review
- Comparing Physical, Pharmacological, Pacemaker, and Cardioneuroablation Therapies for Patients with Vasovagal Syncope: A systematic review and networkInternational journal of cardiology. Heart & vasculature · 2026Article
2 more citing papers are in PubMed but not listed here.
Corrections and comments
- Erratum issued
Authors and funding
30 authors.
Tolga AksuDepartment of Cardiology, Yeditepe University Hospital, İçerenköy Mah. Hastahane Sok. 4,4/1 34752 Ataşehir/İstanbul, Turkey.ORCID 0000-0001-8061-9660
Michele BrignoleDepartment of Cardiology, IRCCS Istituto Auxologico Italiano, Hospital S. Luca, Milan, Italy.ORCID 0000-0002-1845-5607
Leonardo CaloDepartment of Cardiology, Policlinico Casilino, Rome, Italy.ORCID 0000-0002-6062-5286
Philippe DebruyneDepartment of Cardiology, Imeldaziekenhuis, 2820 Bonheiden, Belgium.ORCID 0000-0002-2627-1998
Luigi Di BiaseDepartment of Cardiology, Albert Einstein College of Medicine, at Montefiore Hospital, New York, USA.ORCID 0000-0001-6508-4047
Jean Claude DeharoHôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, France and Aix Marseille Université, C2VN, 13005 Marseille, France.ORCID 0000-0002-1534-3845
Alessandra FanciulliDepartment of Neurology, Medical University of Innsbruck, 6020 Innsbruck, Austria.ORCID 0000-0002-2854-4179
Artur FedorowskiDepartment of Cardiology, Karolinska University Hospital, Solna, Sweden.ORCID 0000-0002-5352-6327
Piotr KulakowskiCentre of Postgraduate Medical Education, Department of Cardiology, Grochowski Hospital, 04-073 Warsaw, Poland.ORCID 0000-0001-7483-3513
Carlos MorilloDepartment of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, T2N 1N4 Calgary, AB, Canada.ORCID 0000-0002-8739-2099
Angel MoyaDepartment of Cardiology, Hospital Universitari Dexeus, 08028 Barcelona, Spain.ORCID 0000-0003-2038-717X
Roman PiotrowskiCentre of Postgraduate Medical Education, Department of Cardiology, Grochowski Hospital, 04-073 Warsaw, Poland.ORCID 0000-0001-8034-4898
Sebastian StecDivision of Electrophysiology, Cardioneuroablation, Catheter Ablation and Cardiac Stimulation, Subcarpathian Center for Cardiovascular Intervention, Sanok, Poland.ORCID 0000-0002-9862-318X
Richard SuttonDepartment of Cardiology, Hammersmith Hospital Campus, National Heart & Lung Institute, Imperial College, London, UK.ORCID 0000-0002-5710-1094
J Gert van DijkDepartment of Neurology, Leiden University Medical Centre, Albinusdreef 2, Zuid Holland, 2333 ZA Leiden, The Netherlands.ORCID 0000-0002-6953-7573
Dan WichterleDepartment of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), 14021 Prague, Czechia.ORCID 0000-0002-0448-5143
Hung-Fat TseDepartment of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR.ORCID 0000-0002-9578-7808
Yan YaoArrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.ORCID 0000-0002-4003-4323
Robert S SheldonDepartment of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, T2N 1N4 Calgary, AB, Canada.ORCID 0000-0002-3463-4082
Marmar VaseghiUCLA Cardiac Arrhythmia Center Division of Cardiology, Department of Medicine, University of California, Los Angeles, CA, USA.ORCID 0000-0002-9701-9706
Jose C PachonDante Pazzanese Cardiology Institute, São Paulo Heart Hospital, São Paulo University, São Paulo, Brazil.ORCID 0000-0002-5111-488X
Maurício ScanavaccaArrhythmia Unit-Heart Institute (Incor), University of São Paulo Medical School, Avenida Doutor Enéas Carvalho de Aguiar 44, São Paulo CEP 05403-000, SP, Brazil.ORCID 0000-0001-7327-2275
Christian MeyerDivision of Cardiology/Angiology/Intensive Care, EVK Düsseldorf, Teaching Hospital, University of Düsseldorf, Kirchfeldstraße 40, 40217 Düsseldorf, Germany.
Reshma AminCardiovascular Department, Kings College Hospital NHS Foundation Trust, London, UK.
Dhiraj GuptaDepartment of Cardiology, Liverpool Heart and Chest Hospital, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK.
Massimo MagnanoCardiology Department, Sant'Andrea Hospital, Vercelli, Italy.
Varun MalikCentre for heart Rhythm Disorders, University of Adelaide, Adelaide, Australia.
Patrick SchauerteDepartment of Cardiology, Herzmedizin-Berlin HMB MVZ GmbH, Rudower Chaussee 9, 12489 Berlin, Germany.
Win-Kuang ShenDepartment of Cardiovascular Diseases, Mayo Clinic, Arizona, USA.
Juan Carlos Zerpa AcostaDepartment of Cardiology, HCor Hospital do Coracao, Sao Paulo, SP, Brasil.
Funding
Ventricular arrhythmias and mechanisms of parasympathetic dysfunction following myocardial infarctionR01HL148190 · NHLBI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI VASEGHI, MARMAR · 2020 to 2024
$3.2MSex differences in cardiac autonomic remodeling after myocardial infarctionR01HL170626 · NHLBI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Crystal May Ripplinger, Marmar Vaseghi · 2024 to 2026
$2.1MNHLBI NIH HHS R01 HL148190NHLBI NIH HHS R01 HL170626
Abstract
Cardioneuroablation has emerged as a potential alternative to cardiac pacing in selected cases with vasovagal reflex syncope, extrinsic vagally induced sinus bradycardia-arrest or atrioventricular block. The technique was first introduced decades ago, and its use has risen over the past decade. However, as with any intervention, proper patient selection and technique are a prerequisite for a safe and effective use of cardioneuroablation therapy. This document aims to review and interpret available scientific evidence and provide a summary position on the topic.
Indexed as
BradycardiaSyncope, VasovagalAblation TechniquesCatheter AblationConsensusHeart RateHumansTreatment OutcomeAtrioventricular blockAutonomic nervous systemReflex syncopeSinus bradycardiaVasovagal syncope
Identifiers
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LicenceCC BY
Read underepoch 390
Registered trials
NCT07162740ClinicalTrials.gov
NCT07196397ClinicalTrials.gov
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.