AccScience Publishing / BH / Online First / DOI: 10.36922/bh.4824
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REVIEW

Cardioneuroablation for vagally mediated bradyarrhythmia: A case study with a systematic review

Feng Hu1† ,  Yali Wang2† ,  Minhua Zang1 ,  Bin Xu1 ,  Guangyu Li1 ,  Guangyu Wang1 ,  Zhiqing Qiao1 ,  Lihui Zheng3 ,  Yan Yao3* ,  Jun Pu1*
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1 Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
2 Department of Respiratory Medicine, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
3 Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Brain & Heart, 4824 https://doi.org/10.36922/bh.4824
Submitted: 11 September 2024 | Accepted: 18 November 2024 | Published: 12 December 2024
(This article belongs to the Special Issue The Brain Disorders with Left Atrium)
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

This study evaluates the efficacy of cardioneuroablation (CNA) for vagally mediated bradyarrhythmia (VMB) through two case reports, a systematic review and a meta-analysis. Two patients with VMB were treated with CNA targeting ganglionated plexi using a radiofrequency ablation catheter. Both patients showed sustained clinical improvement post-CNA, with no recurrence of syncope or pre-syncope during follow-up periods of 26 and 16 months. We performed a meta-analysis, according to the preferred reporting items for systematic reviews and meta-analyses guidelines to review 19 studies involving 618 patients, excluding animal studies, case reports, and studies limited to immediate responses. The analysis revealed that 94.3% (95% confidence interval [CI]: 90.9 – 97.7%) of patients were symptom-free during follow-up, while only 4.5% (95% CI: 2.6 – 6.4%) required pacemaker implantation. Procedure-related complications were reported in 4.7% (95% CI: 2.3 – 7.1%) of overall cases. These findings suggest that CNA is an effective and safe treatment option for VMB, reducing symptom recurrence and the need for pacemaker implantation. Further randomized controlled trials are warranted to validate its long-term efficacy.

Keywords
Cardioneuroablation
Vagally mediated bradyarrhythmia
Radiofrequency ablation
Ganglionated plexus
Funding
This work was supported by the Shanghai Municipal Key Clinical Specialty (shslczdzk06204), the Shanghai Professional Technical Service Platform for Biological Sample and Database of Cardiovascular and Cerebrovascular Diseases (22DZ2292400), the Shanghai Clinical Research Center for Aging and Medicine (19MC1910500), and the Shanghai Municipal Health Commission Top Priority Research (2023ZZ02021).
Conflict of interest
Yan Yao is an Editor-in-Chief of this journal and Guest Editor of this special issue but was not in any way involved in the editorial and peer-review process conducted for this paper, directly or indirectly. Separately, other authors declared that they have no known competing financial interests or personal relationships that could have influenced the work reported in this paper.
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Brain & Heart, Electronic ISSN: 2972-4139 Published by AccScience Publishing
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