{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T22:31:33Z","timestamp":1793917893189,"version":"4.8.0"},"reference-count":29,"publisher":"Radcliffe Medical Media Ltd","license":[{"start":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T00:00:00Z","timestamp":1749772800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/legalcode"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arrhythm Electrophysiol Rev"],"abstract":"<jats:p>Inappropriate sinus tachycardia (IST) is a clinical syndrome that generally affects young patients and is associated with distressing symptoms. Cardioneuroablation (CNA) is a promising method for the treatment of asystolic reflex syncope, functional bradycardia or atrioventricular block. Because CNA involves parasympathetic denervation, one potential adverse effect may be IST. We present an educational case of a patient with mixed vasovagal syncope and symptomatic sinus bradycardia who underwent CNA, as a result of which bradycardia converted to IST and the patient required subsequent pacemaker implantation. We also review the incidence of IST after CNA and\u00a0difficulties around the definition and treatment of post-CNA IST.<\/jats:p>","DOI":"10.15420\/aer.2025.01","type":"journal-article","created":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T10:36:53Z","timestamp":1749811013000},"source":"Crossref","is-referenced-by-count":6,"title":["Inappropriate Sinus Tachycardia Following Cardioneuroablation for Reflex Syncope: A Case Report and Review of the Literature Illustrating this Underappreciated Adverse Effect"],"prefix":"10.15420","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7483-3513","authenticated-orcid":false,"given":"Piotr","family":"Kulakowski","sequence":"first","affiliation":[{"name":"Department of Cardiology, Medical Centre for Postgraduate Education, Grochowski Hospital, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roman","family":"Piotrowski","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Medical Centre for Postgraduate Education, Grochowski Hospital, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6096","published-online":{"date-parts":[[2025,6,13]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Pachon JCM, Pachon EIM, Cunha Pachon MZ, et al. 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The benefit of cardioneuroablation to reduce syncope recurrence in vasovagal syncope patients: a case-control study. J Interv Card Electrophysiol 2022;63:77\u201386. https:\/\/doi.org\/10.1007\/s10840-020-00938-0; PMID:\u00a033527216.","DOI":"10.1007\/s10840-020-00938-0"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Baysal E, Mutluer FO, Dagsali AE, et al. Improved health-related quality of life after cardioneuroablation in patients with vasovagal syncope. J Interv Card Electrophysiol 2025;68:245\u201352. https:\/\/doi.org\/10.1007\/s10840-022-01420-9; PMID:\u00a036357697.","DOI":"10.1007\/s10840-022-01420-9"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Gopinathannair R, Olshansky B, Turagam MK, et al. Permanent pacing versus cardioneuroablation for cardioinhibitory vasovagal syncope. J Interv Card Electrophysiol 2025;68:203\u201310. https:\/\/doi.org\/10.1007\/s10840-022-01456-x; PMID:\u00a036562915.","DOI":"10.1007\/s10840-022-01456-x"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Piotrowski R, Baran J, Sikorska A, et al. Cardioneuroablation for reflex syncope: efficacy and effects on autonomic cardiac regulation \u2013 a prospective randomized trial. JACC Clin Electrophysiol 2023;9:85\u201395. https:\/\/doi.org\/10.1016\/j.jacep.2022.08.011; PMID:\u00a036114133.","DOI":"10.1016\/j.jacep.2022.08.011"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Candemir B, Baskovski E, Beton O, et al. Procedural characteristics, safety, and follow-up of modified right-sided approach for cardioneuroablation. 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Differential and synergistic effects of right and left atrial ganglionated plexi ablation in patients undergoing cardioneuroablation: results from the ELEGANCE multicenter study. J Interv Card Electrophysiol 2025;68:195\u2013202. https:\/\/doi.org\/10.1007\/s10840-024-01968-8; PMID:\u00a039671156.","DOI":"10.1007\/s10840-024-01968-8"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Barrio-Lopez MT, \u00c1lvarez-Ortega C, Minguito-Carazo C, et al. Predictors of clinical success of cardioneuroablation in patients with syncope: results of a multicenter study. JACC Clin Electrophysiol 2024;10:2711\u201324. https:\/\/doi.org\/10.1016\/j.jacep.2024.07.027; PMID:\u00a039453292.","DOI":"10.1016\/j.jacep.2024.07.027"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Tu B, Lai ZH, Chen AY, et al. Effectiveness of cardioneuroablation in different subtypes of vasovagal syncope. J Geriatr Cardiol 2024;21:651\u20137. https:\/\/doi.org\/10.26599\/1671-5411.2024.06.004; PMID:\u00a038973824.","DOI":"10.26599\/1671-5411.2024.06.004"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Choi NH, Hong J, Moak JP. Cardioneuroablation for pediatric patients with functional sinus node dysfunction and paroxysmal atrioventricular block. J Cardiovasc Electrophysiol 2024;35:221\u20139. https:\/\/doi.org\/10.1111\/jce.16145; PMID:\u00a038038245.","DOI":"10.1111\/jce.16145"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"Joza J, Gustavo Bravosi da Rosa L, Alturki A, et al. Cardioneuroablation as a strategy to prevent pacemaker implantation in young patients with vasovagal syncope. Int J Cardiol Heart Vasc 2024;51:101360. https:\/\/doi.org\/10.1016\/j.ijcha.2024.101360; PMID:\u00a038379634.","DOI":"10.1016\/j.ijcha.2024.101360"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"Olshansky B, Sullivan RM. Inappropriate sinus tachycardia. 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Europace 2024;26:euae206. https:\/\/doi.org\/10.1093\/europace\/euae206; PMID:\u00a039082698."},{"key":"ref21","doi-asserted-by":"publisher","unstructured":"Pachon-M JC, Pachon-M EI, Pachon CTC, et al. Long-term evaluation of the vagal denervation by cardioneuroablation using Holter and Heart Rate variability. Circ Arrhythm Electrophysiol 2020;13:e008703. https:\/\/doi.org\/10.1161\/CIRCEP.120.008703; PMID:\u00a033198486.","DOI":"10.1161\/circep.120.008703"},{"key":"ref22","doi-asserted-by":"crossref","unstructured":"Sheldon RS, Grubb BP, Olshansky B, et al. 2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart Rhythm 2015;12:e41\u201363. https:\/\/doi.org\/10.1016\/j.hrthm.2015.03.029; PMID:\u00a025980576.","DOI":"10.1016\/j.hrthm.2015.03.029"},{"key":"ref23","doi-asserted-by":"publisher","unstructured":"Brembilla-Perrot B, Sellal JM, Olivier A, et al. Recurrences of symptoms after AV node re-entrant tachycardia ablation: a clinical arrhythmia risk score to assess putative underlying cause. Int J Cardiol 2015;179:292\u20136. https:\/\/doi.org\/10.1016\/j.ijcard.2014.11.071; PMID:\u00a025464467.","DOI":"10.1016\/j.ijcard.2014.11.071"},{"key":"ref24","doi-asserted-by":"publisher","unstructured":"Kanjwal K, Karabin B, Sheikh M, et al. New onset postural orthostatic tachycardia syndrome following ablation of AV node reentrant tachycardia. J Interv Card Electrophysiol 2010;29:53\u20136. https:\/\/doi.org\/10.1007\/s10840-010-9506-4; PMID:\u00a020711750","DOI":"10.1007\/s10840-010-9506-4"},{"key":"ref25","doi-asserted-by":"publisher","unstructured":"Pappone C, Santinelli V, Manguso F, et al. Pulmonary vein denervationenhanceslong-termbenefitaftercircumferential ablation for paroxysmal atrial fibrillation. Circulation 2004;109:327\u201334. https:\/\/doi.org\/10.1161\/01.CIR.0000112641.16340.C7; PMID:\u00a014707026.","DOI":"10.1161\/01.cir.0000112641.16340.c7"},{"key":"ref26","doi-asserted-by":"publisher","unstructured":"Katritsis GD, Katritsis DG. Cardiac autonomic denervation for ablation of atrial fibrillation. Arrhythm Electrophysiol Rev 2014;3:113\u20135. https:\/\/doi.org\/10.15420\/aer.2014.3.2.113; PMID:\u00a026835076.","DOI":"10.15420\/aer.2014.3.2.113"},{"key":"ref27","doi-asserted-by":"publisher","unstructured":"Os\u00f3rio TG, Chierchia GB, Maj R, et al. Standardized quantification of vagal denervation by extracardiac vagal stimulation during second generation cryoballoon ablation: a vein per vein analysis. J Atr Fibrillation 2019;12:2223. https:\/\/doi.org\/10.4022\/jafib.2223. PMID:\u00a032435337.","DOI":"10.4022\/jafib.2233"},{"key":"ref28","doi-asserted-by":"publisher","unstructured":"Sikorska A, Pilichowska-Paszkiet E, Zuk A, et al. Acceleration of sinus rhythm following ablation for atrial fibrillation: a simple parameter predicting ablation efficacy. Kardiol Pol 2019;77:960\u20135. https:\/\/doi.org\/10.33963\/kp.14950; PMID:\u00a031456591.","DOI":"10.33963\/kp.14950"}],"container-title":["Arrhythmia &amp; Electrophysiology Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.aerjournal.com\/articleindex\/aer.2025.01","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T10:36:56Z","timestamp":1749811016000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.aerjournal.com\/articleindex\/aer.2025.01"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,13]]},"references-count":29,"URL":"https:\/\/doi.org\/10.15420\/aer.2025.01","relation":{},"ISSN":["2050-3377","2050-3369"],"issn-type":[{"value":"2050-3377","type":"electronic"},{"value":"2050-3369","type":"print"}],"subject":[],"published":{"date-parts":[[2025,6,13]]},"article-number":"e12"}}