Discussion
The data derived from this study indicate that ECVS-guided CNA with vagal denervation confirmation as the endpoint (ECVS group) yields superior long-term outcomes compared to CNA without validation of vagal denervation (NoECVS group), as illustrated in Figure 4. Within this cohort, the ECVS group, which concluded CNA after achieving vagal response abolition19 exhibited a 91% freedom from syncope recurrence at the 5-year mark. In contrast, the NoECVS group, which performed CNA without ECVS control, had a 63% likelihood of remaining free from syncope during the same period, as depicted in Figure 4-A. The cumulative risk function illustrates a Hazard Ratio (HR) of 4.69, with a 95% confidence interval and a p-value of 0.047, as shown in Figure 4-B. Therefore, in the ECVS group, the probability of syncope recurrence was 4.7 times lower than that in the NoECVS group, which conducted CNA without confirmation of vagal denervation by ECVS.