Cardioinhibitory reflex syncope : Cardioneuroablation as a therapeutic alternative.

The case of a 36-year-old female patient with recurrent reflex syncope characterized by predominant cardioinhibition and episodes of asystole lasting up to 9 s, as documented by an implantable loop recorder, is reported. Given her young age and symptomatic burden, cardioneuroablation (CNA) was performed without complications as an alternative to pacemaker implantation, in accordance with European Heart Rhythm Association (EHRA) recommendations. In this case, CNA has shown to be an effective and safe treatment option for managing recurrent cardioinhibitory reflex syncope. CNA should particularly be considered and offered in specialised centres for symptomatic patients under 40 years of age, in which treatment options beyond conservative measures remain limited.