{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T23:54:36Z","timestamp":1785801276063,"version":"3.56.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2020,9,1]],"date-time":"2020-09-01T00:00:00Z","timestamp":1598918400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Previous reports have suggested that cardioneuroablation (CNA) can be effective in reducing syncopal recurrences in patients with vasovagal syncope (VVS). This study assessed the efficacy of CNA in preventing a positive response to head-up tilt testing (HUT).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>This is a single-centre retrospective study reviewing prospectively collected data. Fifty-one consecutive patients with VVS were included in the study. After confirmation of &amp;gt;3\u2009s asystole on HUT, all patients underwent CNA. Head-up tilt testing was repeated 1\u2009month after CNA. The main outcome measures were recurrence of syncope episode and positive response on HUT. During a median follow-up period of 11\u2009months (interquartile range 3\u201327\u2009months), all but 3 (5.8%) of 51 patients were free of syncope. Repeated HUTs were negative in 44 (86.2%) patients. When patients with recurrent syncope were excluded, vasodepressor response was seen in three cases and cardioinhibitory response in one case, respectively. Cardioneuroablation caused significant and durable shortening of RR interval in all cases. This effect was significantly higher in patients without positive HUT responses.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This pilot study shows that CNA can effectively prevent recurrent syncopal episodes in patients with refractory VVS. Head-up tilt testing seems as a valuable diagnostic tool not only to select suitable candidates and but also to evaluate success of CNA.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euaa230","type":"journal-article","created":{"date-parts":[[2020,7,10]],"date-time":"2020-07-10T19:10:57Z","timestamp":1594408257000},"page":"1320-1327","source":"Crossref","is-referenced-by-count":53,"title":["Usefulness of post-procedural heart rate response to predict syncope recurrence or positive head up tilt table testing after cardioneuroablation"],"prefix":"10.1093","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8061-9660","authenticated-orcid":false,"given":"Tolga","family":"Aksu","sequence":"first","affiliation":[{"name":"Department of Cardiology, University of Health Sciences, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tumer Erdem","family":"Guler","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Health Sciences, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serdar","family":"Bozyel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Health Sciences, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kivanc","family":"Yalin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakesh","family":"Gopinathannair","sequence":"additional","affiliation":[{"name":"Kansas City Heart Rhythm Institute and Research Foundation, Overland Park, KS, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,9,4]]},"reference":[{"key":"2020101222144266900_euaa230-B1","doi-asserted-by":"crossref","first-page":"1883","DOI":"10.1093\/eurheartj\/ehy037","article-title":"2018 ESC Guidelines for the diagnosis and management of syncope","volume":"39","author":"Brignole","year":"2018","journal-title":"Eur Heart J"},{"key":"2020101222144266900_euaa230-B2","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1007\/s10286-008-0484-x","article-title":"Is there any point to vasovagal syncope?","volume":"18","author":"van Dijk","year":"2008","journal-title":"Clin Auton Res"},{"key":"2020101222144266900_euaa230-B3","first-page":"CD004194","article-title":"Drugs and pacemakers for vasovagal, carotid sinus and situational syncope","volume":"10","author":"Romme","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"2020101222144266900_euaa230-B4","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1161\/01.CIR.102.3.294","article-title":"Dual-chamber pacing in the treatment of neurally mediated tilt-positive cardioinhibitory syncope: pacemaker versus no therapy: a multicenter randomized study. 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The vasovagal syncope and pacing trial (SYNPACE)","volume":"25","author":"Raviele","year":"2004","journal-title":"Eur Heart J"},{"key":"2020101222144266900_euaa230-B6","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1093\/europace\/eux015","article-title":"Effects of closed-loop stimulation vs. DDD pacing on haemodynamic variations and occurrence of syncope induced by head-up tilt test in older patients with refractory cardioinhibitory vasovagal syncope: the Tilt test-Induced REsponse in Closed-loop Stimulation multicentre, prospective, single blind, randomized study","volume":"20","author":"Palmisano","year":"2018","journal-title":"Europace"},{"key":"2020101222144266900_euaa230-B7","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1093\/europace\/eur163","article-title":"Catheter ablation of severe neurally meditated reflex (neurocardiogenic or vasovagal) syncope: cardioneuroablation long-term results","volume":"13","author":"Pachon","year":"2011","journal-title":"Europace"},{"key":"2020101222144266900_euaa230-B8","doi-asserted-by":"crossref","first-page":"95","DOI":"10.15420\/aer.2018.22.2","article-title":"Pacing for vasovagal syncope","volume":"7","author":"Gopinathannair","year":"2018","journal-title":"Arrhythm Electrophysiol Rev"},{"key":"2020101222144266900_euaa230-B9","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1111\/pace.12756","article-title":"Simplified cardioneuroablation in the treatment of reflex syncope, functional AV block, and sinus node dysfunction","volume":"39","author":"Aksu","year":"2016","journal-title":"Pacing Clin Electrophysiol"},{"key":"2020101222144266900_euaa230-B10","doi-asserted-by":"crossref","first-page":"e006604","DOI":"10.1161\/CIRCEP.118.006604","article-title":"Unifocal right-sided ablation treatment for neurally mediated syncope and functional sinus node dysfunction under computed tomographic guidance","volume":"11","author":"Debruyne","year":"2018","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2020101222144266900_euaa230-B11","doi-asserted-by":"crossref","first-page":"e003471","DOI":"10.1161\/JAHA.116.003471","article-title":"Catheter ablation as a treatment for vasovagal syncope: long-term outcome of endocardial autonomic modification of the left atrium","volume":"5","author":"Sun","year":"2016","journal-title":"J Am Heart Assoc"},{"key":"2020101222144266900_euaa230-B12","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1007\/s10840-018-0421-4","article-title":"Electroanatomic-mapping-guided cardioneuroablation versus combined approach for vasovagal syncope: a cross-sectional observational study","volume":"54","author":"Aksu","year":"2019","journal-title":"J Interv Card Electrophysiol"},{"key":"2020101222144266900_euaa230-B13","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1016\/j.hrthm.2019.07.018","article-title":"Right anterior ganglionated plexus: the primary target of cardioneuroablation?","volume":"16","author":"Hu","year":"2019","journal-title":"Heart Rhythm"},{"key":"2020101222144266900_euaa230-B14","first-page":"33","article-title":"Cardioneuroablation in the treatment of neurally mediated reflex syncope: a review of the current literature","volume":"45","author":"Aksu","year":"2017","journal-title":"Turk Kardiyol Dern Ars"},{"key":"2020101222144266900_euaa230-B15","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1016\/S0140-6736(86)91665-X","article-title":"Head-up tilt: a useful test for investigating unexplained syncope","volume":"327","author":"Kenny","year":"1986","journal-title":"Lancet"},{"key":"2020101222144266900_euaa230-B16","doi-asserted-by":"crossref","first-page":"1825","DOI":"10.1136\/heartjnl-2013-304399","article-title":"Diagnosis of neurally mediated syncope at initial evaluation and with tilt table testing compared with that revealed by prolonged ECG monitoring. 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