Patients Groups
ECVS Group: This group comprised 34 cases in which ECVS was performed
prior to CNA to record the baseline vagal response. CNA targeted the
anatomical landmarks described earlier. Following each step, a repeat
ECVS was conducted to assess the degree of denervation. If the
anatomical approach proved insufficient, CNA was extended based on
fractionation mapping until achieving complete or near-total
elimination of the vagal response.
NoECVS Group: This group included 14 cases in which mapping relied on
anatomical landmarks and regions rich in AF-Nests, as detected by
Fractionation Mapping. The progression of denervation was inferred
from the increase in heart rate and the Wenckebach’s point. At the
conclusion, an atropine test was administered, and the endpoint was
deemed satisfactory if there was no response to atropine or if it was
not significant.
All patients underwent close monitoring for an average duration of
30.1±16 months, with regular office visits scheduled at 3, 6, and
12-month intervals. Additionally, active communication via phone, email,
ECG smartwatch, and social media was maintained to inquire about syncope
recurrence and any related symptoms.