{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T05:04:28Z","timestamp":1779858268236,"version":"3.53.1"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Vasovagal syncope (VVS) poses challenges despite therapy, and optimal cardioneuroablation (CNA) targeting ganglionated plexi (GPs) remains debated. This study compared long\u2010term efficacy and safety between empirical anatomical\u2010guided CNA (EAGC) and high\u2010amplitude fractionated electrogram (HAFE)\u2010guided CNA in patients with refractory VVS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This single\u2010center retrospective analysis (July 2018 to July 2023) included 109 patients with refractory VVS undergoing CNA. Patients were divided into the EAGC group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200970; empirical GP ablation at common anatomical sites) or the HAFE group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200939; HAFE mapping\u2010guided GP ablation). The primary endpoint was 24\u2010month syncope\u2010free survival; secondary endpoints included procedural metrics, quality of life (QoL, via syncope dysfunction score [SDS]), and procedure\u2010related complications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      No significant difference in 24\u2010month syncope\u2010free survival was observed between groups (HR\u2009=\u20091.648, 95% CI 0.648\u20134.194; log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.285), with rates of 85.6% in the EAGC group and 77.2% in the HAFE group. The HAFE group demonstrated shorter procedure time (median 66.00\u2009min [IQR 52.00\u201387.50] vs. 90.00\u2009min [IQR 71.75\u2013101.50];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and reduced radiation exposure (X\u2010ray dose: 6.00 [IQR 4.17\u201310.75] mGy vs. 12.00 [IQR 6.48\u201320.00] mGy;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) and fluoroscopy time (2.53 [IQR 1.92\u20134.06] min vs. 4.38 [IQR 2.47\u20137.05] min;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) compared to those in the EAGC group. Both groups exhibited significant reductions in syncope dysfunction score (SDS;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), however, the intergroup difference in score reduction failed to reach statistical significance (\u0394SDS;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.487). Complication rates were comparable between two groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>EAGC and HAFE\u2010guided CNA demonstrated comparable 24\u2011month syncope\u2011free survival with no significant difference in recurrence risk, while HAFE\u2010guided CNA improved procedural efficiency.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/clc.70348","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T10:20:16Z","timestamp":1779099616000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Empirical Anatomical Versus HAFE\u2010Guided Cardioneuroablation for Vasovagal Syncope: Long\u2010Term Efficacy and Safety Outcomes"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2613-212X","authenticated-orcid":false,"given":"Bo","family":"Zhang","sequence":"first","affiliation":[{"name":"Health Science Center Ningbo University Ningbo City China"},{"name":"Chinaco Healthcare Corporation Limited International Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianfeng","family":"Du","sequence":"additional","affiliation":[{"name":"Arrhythmia Center The First Affiliated Hospital of Ningbo University, Ningbo First Hospital Ningbo City China"},{"name":"Department of Cardiology, Ningbo No. 2 Hospital Wenzhou Medical University Ningbo City China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9371-6399","authenticated-orcid":false,"given":"Chenxu","family":"Luo","sequence":"additional","affiliation":[{"name":"Health Science Center Ningbo University Ningbo City China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1120-6554","authenticated-orcid":false,"given":"Xinzhi","family":"Yu","sequence":"additional","affiliation":[{"name":"Health Science Center Ningbo University Ningbo City China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6073-5986","authenticated-orcid":false,"given":"Shenyuan","family":"Zhou","sequence":"additional","affiliation":[{"name":"Health Science Center Ningbo University Ningbo City China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongxing","family":"Jiang","sequence":"additional","affiliation":[{"name":"Arrhythmia Center The First Affiliated Hospital of Ningbo University, Ningbo First Hospital Ningbo City China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yin","family":"Xu","sequence":"additional","affiliation":[{"name":"Arrhythmia Center The First Affiliated Hospital of Ningbo University, Ningbo First Hospital Ningbo City China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renyuan","family":"Fang","sequence":"additional","affiliation":[{"name":"Arrhythmia Center The First Affiliated Hospital of Ningbo University, Ningbo First Hospital Ningbo City China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingjun","family":"Feng","sequence":"additional","affiliation":[{"name":"Arrhythmia Center The First Affiliated Hospital of Ningbo University, Ningbo First Hospital Ningbo City China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6971-0313","authenticated-orcid":false,"given":"Caijie","family":"Shen","sequence":"additional","affiliation":[{"name":"Arrhythmia Center The First Affiliated Hospital of Ningbo University, Ningbo First Hospital Ningbo City 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