PO-03-072 CARDIONEUROABLATION AS AN ALTERNATIVE TREATMENT FOR PATIENTS WITH CAROTID SINUS SYNDROME - A MULTICENTER EXPERIENCE

Carotid sinus syndrome (CSS) is an uncommon condition caused by sudden vagal overactivity resulting in arrest, AV block (AVB) and syncope commonly treated with pacemaker (PM). Cardioneuroablation (CNA) aims denervation removing cardio inhibition endocardial ablation Study outcomes of CNA controlled extracardiac stimulation (ECVS) carotid massage (CSM) CSS. Prospective, controlled, clinical study including 11 patients a history repetitive CSS, 3 hospital centers Brazil 1 Spain. Presenting positive massage, pauses > seconds, response to atropine test, ruling out hypotensive component as cause syncope. Bi-atrial identifying AF-Nests (AFN), ablating the P point 4 main areas related ganglionic plexuses (GP). Vagal control ECVS was used define extension denervation, addition CSM performed confirm immediate success at end ablation, defining higher effect. Primary endpoint: eliminate AVB CSM. Secondary points: Time event after CNA, time diagnose induced Mean age 55,9(±16,3), mean episodes 7,7 (±6,9). Pre-CNA response: (5,7 ±1,4secs), transient 4/11. Post-CNA, ECVS, Atropine responses were completely abolished 100%. Obtained HR increase (59.1±11,1/80,3±5,1bpm). Follow-up 25,7(±17,1) months, no recurrence. successfully 10/11, patient it not possible advance catheter through any jugular vein, performed; had 6 months FU, PM implanted, without spontaneous events. No complications or proarrhythmic effect registered. Bi atrial AFN/GP based guided abolishment effective, feasible, reproducible for eliminating recurrence all Control using defined extent confirmed success. may be considered option CSS treatment.