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.