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Repeat Cardioneuroablation for Recurrent Syncope
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  • Clinton Thurber,
  • Nathaniel Steiger,
  • Davis R. Sneider,
  • Sunil Kapur
Clinton Thurber
Brigham and Women's Hospital
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Nathaniel Steiger
Brigham and Women's Hospital
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Davis R. Sneider
Abbott Laboratories
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Sunil Kapur
Brigham and Women's Hospital
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Abstract

Introduction: Some patients suffer recurrent syncope following cardioneuroablation (CNA) for vasovagal syncope (VVS), yet no cases of repeat CNA have been described in detail. Methods and Results: Our present patient suffered a recurrence seven months following successful CNA and wished for a repeat CNA. Pre-procedurally, she lacked an atropine response. During CNA, high-frequency stimulation (HFS) at ganglionated plexi (GP) would not trigger cardioinhibitory events. Ablation was delivered based on anatomy and fractionation mapping, producing characteristic tachycardia at 2 GP sites. Conclusion: Repeat CNA is feasible and safe, and characterized by unique physiology.