Since its original description in 2005, catheter ablation techniques, commonly called cardioneuroablation, have emerged as a potential strategy for modulating autonomic function. Multiple investigators have provided observational data on the potential benefits of this technique in a variety of conditions associated with or exacerbated by increased vagal tone such as vasovagal syncope, functional atrioventricular block, and sinus node dysfunction. Patient selection, current techniques including the various mapping strategies, clinical experience, and limitations of cardioablation are reviewed. Finally, while cardioneuroablation has potential to be a treatment option for selected patients with symptoms mediated by hypervagotonia, the document outlines the important knowledge gaps that currently exist and the necessary next steps required before this technique can be widely implemented into clinical practice.

Arrhythmia Center Fuwai Hospital Peking Union Medical College Chinese Academy of Medical Sciences National Center for Cardiovascular Diseases Beijing China

Arrhythmia Service Department of Cardiovascular Disease Mayo Clinic Jacksonville Florida

Dante Pazzanese Cardiology Institute São Paulo Heart Hospital São Paulo University São Paulo Brazil

Department of Cardiology Institute for Clinical and Experimental Medicine Prague Czech Republic

Department of Cardiology Yeditepe University Hospital Istanbul Turkey

Kansas City Heart Rhythm Institute Overland Park Kansas

Pediatric Arrhythmia Service Dante Pazzanese Cardiology Institute São Paulo Heart Hospital São Paulo Brazil

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