Introduction
Cardioneuroablation (CNA) is emerging as a compelling new management option for vasovagal syncope (VVS), one which has grown increasingly prevalent since the first US case was described only three years ago (1,2). The largest CNA cohorts have reported promising success, describing recurrent syncope at rates ranging from only 0-27% on long-term follow up (3-6). Many patients suffering from VVS are young, and standard-of-care management is often ineffective or overly burdensome. CNA may be a promising new option for this segment of the VVS population; however, the question of how to treat the minority who faint again post-CNA must be confronted. To this point, there have been no published reports in the literature describing in detail a repeat CNA procedure in patients with recurrent syncope post-CNA. Herein we describe such a case, our diagnostic findings, and procedural approach.