Vasovagal syncope with isolated atrioventricular block following cardioneuroablation demonstrating distinct innervation of the sinus and atrioventricular nodes

Vasovagal syncope (VVS) is a common and typically benign cause of transient loss of consciousness. Nevertheless, it can cause reduced quality of life and disability, prompting consideration of a pacemaker implant. In younger patients, pacemaker implantation creates a risk-to-benefit dilemma due to the risk of long-term exposure to potential device-related complications.1,2 First described by Pachon and colleagues in 2004, endocardial radiofrequency (RF) catheter ablation of the myocardial tissue adjacent to and containing the autonomic nerve fibers related to the intrinsic cardiac parasympathetic ganglionated plexi (GPs), termed cardioneuroablation (CNA), has been shown in observational cohorts to successfully reduce the burden of VVS in selected patients.