ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2026
Cardioneuroablation in the management of neurocardiogenic syncope with extracranial validation: efficacy and effects on the regulation of the cardiac autonomic system - a combined retrospective-prospective cohort study.
Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- 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
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7 authors.
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Abstract
backgroundNeurocardiogenic syncope (NCS), particularly cardioinhibitory and mixed subtypes, remains a clinical challenge when refractory to conventional therapy. Cardioneuroablation (CNA) targeting the parasympathetic ganglionated plexi has emerged as a novel interventional option. This study evaluates the efficacy of biatrial CNA with extracardiac vagal stimulation (ECVS) validation in preventing recurrence and modulating cardiac autonomic regulation.
methodsA single-center combined retrospective-prospective cohort study was conducted at a fourth-level institution in Colombia, including patients with cardioinhibitory or mixed-type NCS refractory to conventional treatment. CNA was performed targeting both atria with three-dimensional mapping, followed by ECVS via the internal jugular vein for pre/post validation. Primary outcome was the recurrence of syncope. Secondary outcomes included changes in heart rate variability (HRV) and quality of life (QoL) as assessed by 24-hour Holter monitoring and the SF-36 questionnaire, respectively. Mean follow-up was 24 months. Statistical analysis was performed using SPSS Statistics 28.0.0.0.
resultsFifty-three patients (mean age 42.8 ± 10.1 years, 70% cardioinhibitory type) were included. Recurrence occurred in 7 patients (13.2%), with 86.8% syncope-free survival. HRV parameters decreased after CNA (SDNN: 137.03ms vs. 83.18ms; SDANN index: 79.12 vs. 39.35; RMSSD: 38.75ms vs. 13.91ms; p < 0.001), indicating vagal suppression. QoL improved significantly (SF-36 score: 81.91 vs. 94.62, p < 0.001). No major procedural complications or mortality were reported.
conclusionCNA with ECVS validation is effective in reducing syncope recurrence, suppressing excessive parasympathetic tone, and improving QoL in patients with refractory neurocardiogenic syncope. These findings support its use as a therapeutic option in selected patients.
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