Limitations
A limitation of this study is the relatively small number of patients in
the NoECVS group (2 cases). This can be reasonably explained by the
stringent patient selection criteria applied to both groups, and it
underscores the ethical concerns regarding uncontrolled CNA without ECVS
confirmation. However, the statistical analysis demonstrates that the
two groups are sufficiently equivalent and suitable for comparison. It
is crucial to recognize that patient selection was rigorously conducted,
and the number of cases with predominantly cardioinhibitory
neurocardiogenic syncope is inherently limited, as only severe cases
with complete resistance to conservative treatment were included.
Additionally, only cases performed by three highly trained operators
were included to ensure maximum equivalence and technical
reproducibility of the procedures.