Cardioneuroablation for the treatment of reflex syncope and functional bradyarrhythmias: A Scientific Statement of the European Heart Rhythm Association (EHRA) of the ESC, the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS) and the Latin American Heart Rhythm Society (LAHRS)

Author:

Aksu Tolga1ORCID,Brignole Michele2ORCID,Calo Leonardo3ORCID,Debruyne Philippe4ORCID,Di Biase Luigi5ORCID,Deharo Jean Claude6ORCID,Fanciulli Alessandra7ORCID,Fedorowski Artur8910ORCID,Kulakowski Piotr11ORCID,Morillo Carlos1213ORCID,Moya Angel14ORCID,Piotrowski Roman11ORCID,Stec Sebastian15ORCID,Sutton Richard16ORCID,van Dijk J Gert17ORCID,Wichterle Dan18ORCID,Tse Hung-Fat19ORCID,Yao Yan20ORCID,Sheldon Robert S12ORCID,Vaseghi Marmar21ORCID,Pachon Jose C22ORCID,Scanavacca Maurício23ORCID,Meyer Christian24,Amin Reshma25,Gupta Dhiraj26,Magnano Massimo27,Malik Varun28,Schauerte Patrick2930,Shen Win-Kuang3132,Acosta Juan Carlos Zerpa33

Affiliation:

1. Department of Cardiology, Yeditepe University Hospital , İçerenköy Mah. Hastahane Sok. 4,4/1 34752 Ataşehir/İstanbul , Turkey

2. Department of Cardiology, IRCCS Istituto Auxologico Italiano, Hospital S. Luca , Milan , Italy

3. Department of Cardiology, Policlinico Casilino , Rome , Italy

4. Department of Cardiology, Imeldaziekenhuis , 2820 Bonheiden , Belgium

5. Department of Cardiology, Albert Einstein College of Medicine, at Montefiore Hospital , New York , USA

6. Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, France and Aix Marseille Université, C2VN , 13005 Marseille , France

7. Department of Neurology, Medical University of Innsbruck , 6020 Innsbruck , Austria

8. Department of Cardiology, Karolinska University Hospital , Solna , Sweden

9. Department of Medicine, Karolinska Institute , 171 76 Stockholm , Sweden

10. Department of Clinical Sciences, Lund University , 202 13 Malmö , Sweden

11. Centre of Postgraduate Medical Education, Department of Cardiology, Grochowski Hospital , 04-073 Warsaw , Poland

12. Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary , T2N 1N4 Calgary, AB , Canada

13. Molecular Arrhythmias, Centro Nacional de Investigaciones Cardiovasculares (CNIC) Carlos III C. de Melchor Fernández Almagro , 3, 28029, Madrid , España

14. Department of Cardiology, Hospital Universitari Dexeus , 08028 Barcelona , Spain

15. Division of Electrophysiology, Cardioneuroablation, Catheter Ablation and Cardiac Stimulation, Subcarpathian Center for Cardiovascular Intervention , Sanok , Poland

16. Department of Cardiology, Hammersmith Hospital Campus, National Heart & Lung Institute, Imperial College , London , UK

17. Department of Neurology, Leiden University Medical Centre , Albinusdreef 2, Zuid Holland, 2333 ZA Leiden , The Netherlands

18. Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM) , 14021 Prague , Czechia

19. Department of Medicine, The University of Hong Kong , Pokfulam , Hong Kong SAR

20. Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China

21. UCLA Cardiac Arrhythmia Center Division of Cardiology, Department of Medicine, University of California , Los Angeles, CA , USA

22. Dante Pazzanese Cardiology Institute, São Paulo Heart Hospital, São Paulo University , São Paulo , Brazil

23. Arrhythmia Unit-Heart Institute (Incor), University of São Paulo Medical School , Avenida Doutor Enéas Carvalho de Aguiar 44, São Paulo CEP 05403-000, SP , Brazil

24. Division of Cardiology/Angiology/Intensive Care, EVK Düsseldorf, Teaching Hospital, University of Düsseldorf , Kirchfeldstraße 40, 40217 Düsseldorf , Germany

25. Cardiovascular Department, Kings College Hospital NHS Foundation Trust , London , UK

26. Department of Cardiology, Liverpool Heart and Chest Hospital, Faculty of Health and Life Sciences, University of Liverpool , Liverpool , UK

27. Cardiology Department, Sant'Andrea Hospital , Vercelli , Italy

28. Centre for heart Rhythm Disorders, University of Adelaide , Adelaide , Australia

29. Department of Cardiology, Herzmedizin-Berlin HMB MVZ GmbH , Rudower Chaussee 9, 12489 Berlin , Germany

30. Interventionelle Kardiologie DGK, Herzinsuffizienz DGK , Germany

31. Department of Cardiovascular Diseases, Mayo Clinic , Arizona , USA

32. Department of Cardiology, Mayo Clinic College of Medicine , Rochester, MN , USA

33. Department of Cardiology, HCor Hospital do Coracao , Sao Paulo, SP , Brasil

Abstract

Abstract Cardioneuroablation has emerged as a potential alternative to cardiac pacing in selected cases with vasovagal reflex syncope, extrinsic vagally induced sinus bradycardia-arrest or atrioventricular block. The technique was first introduced decades ago, and its use has risen over the past decade. However, as with any intervention, proper patient selection and technique are a prerequisite for a safe and effective use of cardioneuroablation therapy. This document aims to review and interpret available scientific evidence and provide a summary position on the topic.

Publisher

Oxford University Press (OUP)

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