Conclusion
Herein we report the first detailed case of repeat CNA in a patient with
recurrent VVS despite successful CNA seven months prior. Repeat CNA
after recurrent VVS is both feasible and safe. It may be characterized
by a blunted chronotropic response to atropine and a failure to
redemonstrate bradycardic responses to HFS. It may reproduce
chronotropic evidence of vagal denervation after prior post-CNA recovery
of the same. Repeat CNA lacks well-defined patient selection criteria
and consensus procedural protocols, including optimal means of vagal
denervation testing. The present case underscores the importance of
elucidating these measures.
Acknowledgements: none