Work

Cardioneuroablation for Refractory Vasovagal Storm Secondary to a Right Hilar Tumor

Year: 2025

Type: article

Abstract: BACKGROUND: Cardiac syncope due to sinus arrest may result from either a vasovagal cardioinhibitory mechanism or an intrinsic sinus node dysfunction. CASE SUMMARY: A 67-year-old woman with a recently diagnosed right hilar mass presented with new-onset episodes of syncope associated with sinus arrest. Resting electrocardiogram was normal, and no electrolyte abnormalities were identified. Detailed analysis of telemetry recordings revealed a typical vasovagal cardioinhibitory response. The patient underwent a cardioneuroablation procedure. Since the procedure, there has been no recurrence of syncope or evidence of sinus pause. DISCUSSION: A vasovagal cardioinhibitory response may be triggered by mechanical compression of the vagus nerve or ganglionated plexi. Cardioneuroablation represents a valuable alternative to permanent pacemaker implantation and should be considered in appropriately selected patients. TAKE-HOME MESSAGE: This case highlights the diagnostic telemetry features of vasovagal cardioinhibitory response in an unusual cause of vasovagal syncope, guiding appropriate management with cardioneuroablation.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.104932