First experience with a new tool for automatic mapping of fragmented signals in a case report of cardioneuroablation

Cardioneuroablation is a treatment option for patients with recurrent vasovagal syncope (VVS). Ablation targets of parasympathetic ganglionated plexi (GP) adjacent to the right and left atrial walls and distal endocardial inputs of these GP can be identified both by their anatomical localization and by intracardiac mapping of fragmented electrogram signals. In this case of a successful cardioneuroablation of a 22-year-old patient suffering from recurrent VVS, a new algorithm for automatic mapping of fragmented signals (CARTO Elevate Module, Biosense Webster) was used to identify areas of GP. In this first experience, automatic tags of fragmented signals were matching well with anatomically guided ablation points. This new tool for automatic identification of fragmented signals may facilitate and improve cardioneuroablation procedures.