Patients Groups
ECVS Group: This group comprised 34 cases in which ECVS was performed prior to CNA to record the baseline vagal response. CNA targeted the anatomical landmarks described earlier. Following each step, a repeat ECVS was conducted to assess the degree of denervation. If the anatomical approach proved insufficient, CNA was extended based on fractionation mapping until achieving complete or near-total elimination of the vagal response.
NoECVS Group: This group included 14 cases in which mapping relied on anatomical landmarks and regions rich in AF-Nests, as detected by Fractionation Mapping. The progression of denervation was inferred from the increase in heart rate and the Wenckebach’s point. At the conclusion, an atropine test was administered, and the endpoint was deemed satisfactory if there was no response to atropine or if it was not significant.
All patients underwent close monitoring for an average duration of 30.1±16 months, with regular office visits scheduled at 3, 6, and 12-month intervals. Additionally, active communication via phone, email, ECG smartwatch, and social media was maintained to inquire about syncope recurrence and any related symptoms.