María E. Amrein, Sección de Electrofisiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Christian M. Delgado, Sección de Electrofisiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Agustín E. Monzón, Sección de Electrofisiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Marco Borja, Sección de Electrofisiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Gonzalo Fernández-Villar, Sección de Electrofisiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Gustavo F. Maid, Sección de Electrofisiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Cardioneuroablation was proposed more than two decades ago as a strategy to treat functional bradyarrhythmias without implanting a pacemaker. The case of a 63-year-old male patient with a history of repeated syncope is presented. He was admitted to the coronary care unit due to a positive tilt test, with a cardioinhibitory response (high-grade AVB) and a positive atropine test. It was interpreted as functional AV block and a cardioneuroablation procedure was scheduled. After the procedure he presented a nodal rhythm at 45 b.p.m. that persisted for more than 48 hours, so a definitive dual-chamber pacemaker was implanted. During ambulatory device follow up, 10 days later, sinus rhythm was observed with preserved AV conduction at 75 b.p.m., without pacemaker stimulation. This case is of interest because the time to response after the procedure has not been clearly defined in previous studies.
Keywords: Cardioneuroablation. Ablation. Pacemaker. Tilt test.