Successful Cardioneuroablation for Drug Refractory Vasovagal Syncope after COVID-19 Infection (JACC Case Reports July 2024)-Article: Cardioneuroablation for Drug Refractory Vasovagal Syncope After COVID-19 Infection

Article: Cardioneuroablation for Drug Refractory Vasovagal Syncope After COVID-19 Infection

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The document describes a case report of a 30-year-old woman with drug-refractory vasovagal syncope following COVID-19 infection, successfully treated with cardioneuroablation. The patient experienced presyncope and syncopal episodes post-infection, interfering with daily activities and work. Conservative management and medications like Midodrine were ineffective, leading to the decision to perform cardioneuroablation. The procedure targeted ganglionated plexi around the atria to reduce vagal input to the heart. Mapping and ablation successfully managed the patient's symptoms with no pauses recorded, allowing her to return to full-duty police work. The study highlights the effectiveness of cardioneuroablation for treating cardioinhibitory vasovagal syncope and suggests its consideration for patients experiencing persistent dysautonomia after COVID-19 infection. Larger trials are needed to confirm its utility in these cases. The document also discusses the pathophysiology of vasovagal syncope, autonomic dysfunction post-COVID-19, and the efficacy of cardioneuroablation compared to traditional treatments for vasovagal syncope. It concludes by emphasizing the need for further studies on the long-term safety and efficacy of cardioneuroablation in managing vasovagal syncope.

Keywords

vasovagal syncope

COVID-19 infection

cardioneuroablation

drug-refractory

presyncope

syncopal episodes

Midodrine

ganglionated plexi

dysautonomia

autonomic dysfunction