Abstract
Background: Cardioneuroablation (CNA) of atrial ganglionated plexi (GP) using radiofrequency anergy has shown to be effective in treating refractory neurocardiogenic syncope (NS) during a short-term follow-up. However, there is no study of CNA in patients with postural orthostatic tachycardia syndrome (POTS) with syncope. Methods: Eight patients (mean age 39+9 years, male: 62%) with treatment-refractory (NS: 4, POTS: 4) syncope underwent CNA of all 4 GPs of the left atrium and followed for 35 + 10 months. Results: All patients were non-responders to lifestyle modification and multiple drug therapies including (fludrocortisone, midodrine, beta-blockers, clonidine and pyridostigmine). Syncope recurred only in 3 (37.5%) patients after a mean duration of 34.9 + 15 months. Syncope recurred in 2 of 4 (50%) patients with NS and in 1 of 4 (25%) patients with POTS. Conclusions: Contrary to prior publications, syncope recurs in 37.5% patients during long-term follow up after CAN in both POTS and NS patients.
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