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A. Basics
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D. Heart Failure
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
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21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
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28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
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Long-term outcome of Cardioneuromodulation for Cardioinhibitory Vasovagal Syncope
Session:
Sessão de Posters 09 - Síncope, ILR e cardioneuromodulação
Speaker:
Sílvia Ribeiro
Congress:
CPC 2026
Topic:
C. Arrhythmias and Device Therapy
Theme:
07. Syncope and Bradycardia
Subtheme:
07.4 Syncope and Bradycardia - Treatment
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Sílvia Ribeiro; Mário Oliveira; Paulo Fonseca; Lucy Calvo; Tiago Constantino; Sérgio Laranjo; Pedro Silva e Cunha; João Almdeida; Víctor Sanfins; Ricardo Fontes de Carvalho; António Lourenço; João Primo
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong>Introduction</strong><br /> Vasovagal syncope is the most frequent form of syncope in the general population. Conventional conservative measures are often insufficient for its successful treatment. Autonomic modulation with atrial ganglionated plexi ablation (CNA) has emerged as a treatment option for cardioinhibitory reflex (CI) syncope, specially in young patients, to avoid definitive cardiac pacing.</span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong>Methods</strong><br /> A retrospective study aimed at characterizing the population undergoing CNA for CI syncope, using extracardiac vagal stimulation to assess the intra-procedural acute endpoint of vagal response abolition. </span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong>Results</strong><br /> The sample includes 52 patients (70% male, mean age - 43 years). The EnSiteX mapping system with Emphasis mapping software for ganglion localition was used in 26 patients, while the Carto system was used in 26 patients. </span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif">Extracardiac vagal stimulation induced significant sinus pauses in 8.3% of patients, complete atrioventricular block (AVB) in 8.3%, and a mixed response (sinus pauses + AVB) in 83.3%. In most patients (80%) CNA targeted more than one ganglionated plexos group. The mean procedure time was 105 minutes, with a mean radiation dose of 67.92 mGy, a mean of 34 radiofrequency (RF) applications, and a mean RF time of 16 minutes. Times were longer when the intra-procedural response was AV block. In 92% of the cases, it was possible to completely eliminate the intra-procedural vagal response. The mean number of RF applications and RF time were lower when using Emphasis mapping software. No complications associated with the procedure were recorded. Approximately 90% of patients did not present syncope recurrence during a follow-up ranging between 1 and 5 years.</span></span></p> <p style="text-align:justify"> </p> <p><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong>Conclusions</strong><br /> CNA guided by extra-cardiac vagal stimulation offers a safe and successful treatment option for CI vasovagal syncope, showing excellent long-term results in a young population. Larger studies are needed to confirm these findings.</span></span></p>
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