Cardioneuroablation as a treatment for reflex neurocardiogenic syncope - Case report

Abstract Reflex neurocardiogenic syncope is one of the most common causes of transient loss of consciousness. Pathophysiological mechanism consists of an excessive response of parasympathetic nervous system, which leads to a drop in blood pressure and/or heart rate. Reflex neurocardiogenic syncope is usually not associated with any organic disease, it has a good prognosis and mortality is not increased. The goal of treatment is improving patient's quality of life. For patients with frequent episodes of reflex neurocardiogenic syncope with predominant cardioinhibitory component, who are unresponsive to all nonpharmacological and pharmacological methods of treatment, and pacemaker implantation is not indicated, there is now a new treatment possibility - cardioneuroablation. In this percutaneous electrophysiological procedure epicardial parasympathetic ganglia are ablated with radiofrequency energy. The result is a partial parasympathetic denervation of the heart, which leads to reduction of parasympathetic influence on heart and hence resolution of symptoms.