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Cardioneuroablation for vasovagal syncope: insights on patients' selection, centre settings, procedural workflow and

Diego Penela1,2, Antonio Berruezo2, Laurent Roten3

  • 1Humanitas Research Center, Milano, Italy.

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
|May 23, 2024
PubMed

Insights

Cardioneuroablation (CNA) for vasovagal syncope (VVS) is increasingly used in Europe. While perceived as effective and safe, standardization of procedures and patient management is needed.

Area of Science:

  • Cardiology
  • Autonomic Nervous System Research
  • Interventional Electrophysiology

Background:

  • Recurrent vasovagal syncope (VVS) significantly impacts quality of life.
  • Cardioneuroablation (CNA) targets parasympathetic cardiac autonomic nervous system modulation for VVS.
  • Current European utilization of CNA requires comprehensive assessment.

Purpose of the Study:

  • To provide a comprehensive overview of current Cardioneuroablation (CNA) utilization across Europe.
  • To assess current practices, perceived efficacy, and safety of CNA for VVS.
  • To identify areas for standardization in CNA procedures.

Main Methods:

  • A survey was distributed to 202 participants across 40 European countries.
  • The survey collected data on CNA indications, procedural techniques, and endpoints.
  • Data on peri-procedural management and perceived outcomes were analyzed.

Main Results:

  • Half of respondents performed CNA in the past year, indicating its role as a treatment option.
  • Seventy-one percent systematically target ganglionated plexuses (GPs) in both atria; anatomical and electrogram approaches dominate localization.
  • CNA is perceived as effective (80%) and safe (<1% complications), with high future expectations, though heterogeneity in practice exists.

Conclusions:

  • This survey provides a snapshot of current CNA implementation in Europe.
  • Significant heterogeneity exists in indications, procedural workflow, and endpoints for CNA.
  • Standardization of procedural protocols and peri-procedural patient management is crucial for advancing CNA.
Abstract

Keywords:
CardioneuroablationSurveyVasovagal Syncope

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