Recurrent syncope or vasovagal syncope are episodes of temporary loss of consciousness and postural tone, which recover spontaneously and can have different causes. It is a condition that has historically had few effective treatment alternatives, until cardioneuroablation recently emerged as an innovative procedure that promises relief to patients suffering from recurrent reflex syncope or functional bradycardia, regardless of their age. This medical technique, which selectively interrupts the activity of the parasympathetic nervous system in the heart, has shown significant results in improving the quality of life of affected patients.
Low risk profile
Cardioneuroablation is a therapeutic option with a low risk profile. A study, recently led by Dr. Antonio Berruezo, confirms the effectiveness of this procedure, regardless of the patient’s age. Dr. Berruezo, director of the Department of Arrhythmias at the Quirónsalud Teknon Heart Institute, who coordinated the aforementioned study and the subsequent publication, emphasizes the importance of adequate selection of candidates for cardioneuroablation.
According to Dr. Berruezo, frequent, severe and unavoidable syncope that significantly impacts the patient’s work and social life are the main factors in considering a patient as a suitable candidate for this procedure. Personalization and efficiency of the procedure are focus areas for future improvements.
The study included 60 patients, divided into three groups according to age. The results showed that there were no significant differences between the age groups in response to cardioneuroablation, with an acute success of 93%. More than 90% of patients showed no bradycardia in the tilt-table test after cardioneuroablation, and at eight-month follow-up, 88% of patients were symptom-free. These results support the effectiveness of cardioneuroablation in different age groups.
Younger patients affected by functional or reflex bradycardia that were due to hypertonia of the parasympathetic nervous system, and not a disease of the heart cells, now have new hope. Before cardioneuroablation, the only option in highly symptomatic patients was pacemaker implantation, which presents its own challenges and complications.
Cardioneuroablation is based on interrupting the activity of the parasympathetic autonomic nervous system that innervates the heart, eliminating the severe bradycardia response secondary to its increased activity. Dr. Berruezo concludes that the key to the success of this procedure lies in properly identifying where to apply radiofrequency, and the use of high-resolution CT images has proven to be of great help in this regard.
The study highlights the promising effectiveness of this procedure for patients of all ages suffering from repetitive reflex syncope or functional bradycardia. Cardioneuroablation is emerging as a significantly better alternative for these patients, providing relief and improving their quality of life without the complications associated with previous treatments.
