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.