Minimally Invasive Procedure Shows Promise for Cutting Burde
With this novel catheter-based ablation procedure, operators sought to achieve vagal denervation in people with autonomic bradycardia and/or neurocardiogenic syncope. A retrospective study was based on a multicenter registry of compassionate off-label CNAs. The procedures had been performed from 2016 to 2022 at 13 U.S. centers. Patients were 71 adults who had not responded to medical therapy and/or behavioral modification. They ranged from ages 30 to 64 (mean age 47), and were roughly split between the sexes.

People had a mix of sinus bradycardia (66%), vasovagal syncope (30%), and AV block (4%). This was based on ambulatory monitoring (63%), implantable loop recordings (26%), and tilt-table tests (11%). Radiofrequency (RF) application elicited a parasympathetic response in 59% of compassionate-use patients, and a sympathetic response in 70%. During the procedure, RR intervals shortened from 1047 ms to 775 ms (P<0.001); there were also non-significant decreases in AH interval (from 102 ms to 95 ms) and HV interval (46 to 44 ms). Average RF duration was 612 seconds. Procedural complications were one tamponade and two junctional rhythms.