# Ganglionated plexus ablation of the left atrium for refractory vasovagal syncope: Analysis of the Safety, Effectiveness and Related Factors

## TL;DR

This study shows that ganglionated plexus ablation in the left atrium is a safe and effective treatment for patients with refractory vasovagal syncope.

## Contribution

The study provides new evidence on the safety and effectiveness of GP ablation for refractory vasovagal syncope.

## Key findings

- 76.9% of patients were symptom-free after GP ablation during an 18.7-month follow-up.
- Female sex was associated with a higher likelihood of recurrent vasovagal syncope.
- No procedure-related complications were observed, confirming the safety of the treatment.

## Abstract

To investigate the safety and efficacy of ganglionated plexus ablation of the left atrium for patients with refractory vasovagal syncope.

From May 2019 to December 2023, 39 patients with refractory vasovagal syncope (VVS) underwent ganglionated plexus (GP) ablation at our institution. Associations between post-ablation VVS recurrence and factors including average heart rate on Holter monitoring, preoperative head-up tilt table test (HUTT), for GP identification methods, and sex were analyzed.

During the follow-up period 18.7 months, 30 of the 39 patients (76.9 % vs 23.1 %, p = 0.001) were symptom-free after GP ablation. The remaining 9 patients exhibited significant symptomatic improvement, with a marked reduction in the number of syncopal episodes (2.11 ± 1.27 vs 7.13 ± 3.57, p = 0.00). The mean heart rate after procedure (87.10 ± 11.22 bpm) was significantly higher than pre-procedures (70.33 ± 7.56 bpm, p = 0.00), indicating effective VVS control. Preoperative HUTT classifications and GP localization methods showed no significant association with recurrence, although female sex was associated with a higher likelihood of recurrent VVS. No procedure-related complication occurred.

GP ablation of the left atrium is a safe and effective treatment for patients with refractory vasovagal syncope.