{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T15:59:45Z","timestamp":1791388785696,"version":"4.3.3"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T00:00:00Z","timestamp":1622505600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Cardioneuromodulation is a cardioneuroablative approach aiming to create adequate vagolysis of the sinoatrial node through partial ablation of the anterior right ganglionated plexus.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>We performed an interventional study in patients with recurrent neurally mediated syncope (group A) or functional sinus node dysfunction (group B). Syncope burden, ECG, 24-hour rhythm data, tilt table test, exercise test, and pharmacological challenge with atropine were assessed at baseline and at regular intervals to 12 months.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Fifty patients (31 in group A and 19 in group B) underwent cardioneuromodulation. The mean number of syncopes during the previous 12 months was 9.7\u00b118.2. The procedure was associated with a lower rate of syncope (\u221295%) and presyncope (\u221295%) at 12 months versus baseline (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Thirty-seven patients remained entirely free of syncope at 12 months, and the syncope-free survival curve remained stable between the 12- and 30-month follow-up. After a mean ablation time of 8\u00b14 minutes, the P-P interval shortened by 247\u00b1146 ms (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Basal heart rate (HR) increased by 18% (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and remained stable between 6 and 12 months. At 12 months, the mean HR increased by 12% in the entire cohort (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), reached 23% in patients with baseline mean HR &lt;70 beats per minute (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01), and did not increase in patients with baseline HR &gt;70 beats per minute. Maximum HR during exercise decreased by 10 beats per minute at 1 month (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and was restored at 12 months.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Cardioneuromodulation is a safe and fast treatment giving rise to a long-term partial sinus node vagolysis with no apparent short- or long-term safety concerns or undesirable persisting modifications of the intracardiac autonomous nervous system. The impact on vasoplegia is less clear. Cardioneuromodulation is associated with a good clinical outcome in most patients with neurally mediated syncope or functional sinus node dysfunction. These promising data require confirmation in a multicenter randomized trial.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Registration:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT02954666.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.120.009747","type":"journal-article","created":{"date-parts":[[2021,5,17]],"date-time":"2021-05-17T18:02:01Z","timestamp":1621274521000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":58,"title":["Durable Physiological Changes and Decreased Syncope Burden 12 Months After Unifocal Right-Sided Ablation Under Computed Tomographic Guidance in Patients With Neurally Mediated Syncope or Functional Sinus Node Dysfunction"],"prefix":"10.1161","volume":"14","clinical-trial-number":[{"clinical-trial-number":"nct02954666","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2627-1998","authenticated-orcid":true,"given":"Philippe","family":"Debruyne","sequence":"first","affiliation":[{"name":"Department of Cardiology, Imeldaziekenhuis, Bonheiden, Belgium (P.D., T.R., L.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Rossenbacker","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Imeldaziekenhuis, Bonheiden, Belgium (P.D., T.R., L.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc","family":"Janssens","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Imeldaziekenhuis, Bonheiden, Belgium (P.D., T.R., L.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Collienne","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Cliniques Universitaires Saint-Luc, Woluwe, Belgium (C.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1460-7837","authenticated-orcid":true,"given":"Joris","family":"Ector","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Leuven, Belgium (J.E., P.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3024-1281","authenticated-orcid":true,"given":"Peter","family":"Haemers","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Leuven, Belgium (J.E., P.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1737-1353","authenticated-orcid":true,"given":"Jean-Beno\u00eet","family":"le Polain de Waroux","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AZ Sint-Jan Brugge-Oostende AV, Belgium (J.-B.l.P.d.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8168-8155","authenticated-orcid":true,"given":"Christine","family":"Bazelmans","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Biotronik Belgium, Vilvoorde (C.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Boussy","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AZ Groeninge, Kortrijk, Belgium (T.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7267-4376","authenticated-orcid":true,"given":"William","family":"Wijns","sequence":"additional","affiliation":[{"name":"The Lambe Institute for Translational Medicine and Curam, National University of Ireland, Galway and Saolta University Healthcare Group 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