Cardioneuroablation has emerged as a potential alternative to cardiac pacing in selected cases with vasovagal reflex syncope, extrinsic vagally induced sinus bradycardia-arrest or atrioventricular block. The technique was first introduced decades ago, and its use has risen over the past decade. However, as with any intervention, proper patient selection and technique are a prerequisite for a safe and effective use of cardioneuroablation therapy. This document aims to review and interpret available scientific evidence and provide a summary position on the topic.

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

Arrhythmia Unit Heart Institute University of São Paulo Medical School Avenida Doutor Enéas Carvalho de Aguiar 44 São Paulo CEP 05403 000 SP Brazil

Cardiology Department Sant'Andrea Hospital Vercelli Italy

Cardiovascular Department Kings College Hospital NHS Foundation Trust London UK

Centre for heart Rhythm Disorders University of Adelaide Adelaide Australia

Centre of Postgraduate Medical Education Department of Cardiology Grochowski Hospital 04 073 Warsaw Poland

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

Department of Cardiac Sciences Libin Cardiovascular Institute Cumming School of Medicine University of Calgary T2N 1N4 Calgary AB Canada

Department of Cardiology Albert Einstein College of Medicine at Montefiore Hospital New York USA

Department of Cardiology Hammersmith Hospital Campus National Heart and Lung Institute Imperial College London UK

Department of Cardiology HCor Hospital do Coracao Sao Paulo SP Brasil

Department of Cardiology Herzmedizin Berlin HMB MVZ GmbH Rudower Chaussee 9 12489 Berlin Germany

Department of Cardiology Hospital Universitari Dexeus 08028 Barcelona Spain

Department of Cardiology Imeldaziekenhuis 2820 Bonheiden Belgium

Department of Cardiology Institute for Clinical and Experimental Medicine 14021 Prague Czechia

Department of Cardiology IRCCS Istituto Auxologico Italiano Hospital S Luca Milan Italy

Department of Cardiology Karolinska University Hospital Solna Sweden

Department of Cardiology Liverpool Heart and Chest Hospital Faculty of Health and Life Sciences University of Liverpool Liverpool UK

Department of Cardiology Mayo Clinic College of Medicine Rochester MN USA

Department of Cardiology Policlinico Casilino Rome Italy

Department of Cardiology Yeditepe University Hospital İçerenköy Mah Hastahane Sok 4 4 1 34752 Ataşehir İstanbul Turkey

Department of Cardiovascular Diseases Mayo Clinic Arizona USA

Department of Clinical Sciences Lund University 202 13 Malmö Sweden

Department of Medicine Karolinska Institute 171 76 Stockholm Sweden

Department of Medicine The University of Hong Kong Pokfulam Hong Kong SAR

Department of Neurology Leiden University Medical Centre Albinusdreef 2 Zuid Holland 2333 ZA Leiden The Netherlands

Department of Neurology Medical University of Innsbruck 6020 Innsbruck Austria

Division of Cardiology Angiology Intensive Care EVK Düsseldorf Teaching Hospital University of Düsseldorf Kirchfeldstraße 40 40217 Düsseldorf Germany

Division of Electrophysiology Cardioneuroablation Catheter Ablation and Cardiac Stimulation Subcarpathian Center for Cardiovascular Intervention Sanok Poland

Hôpitaux de Marseille Centre Hospitalier Universitaire La Timone Service de Cardiologie France and Aix Marseille Université C2VN 13005 Marseille France

Interventionelle Kardiologie DGK Herzinsuffizienz DGK Germany

Molecular Arrhythmias Centro Nacional de Investigaciones Cardiovasculares Carlos 3 C de Melchor Fernández Almagro 3 28029 Madrid España

UCLA Cardiac Arrhythmia Center Division of Cardiology Department of Medicine University of California Los Angeles CA USA

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Europace. 2025 Feb 5;27(2):euaf023. doi: 10.1093/europace/euaf023. PubMed

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