Cardioneuroablation for Vasovagal Syncope: An Updated Systematic Review and Single-Arm Meta-Analysis

<b>Background:</b> When conservative therapies are insufficient for vasovagal syncope (VVS), procedural options such as permanent pacemakers or catheter ablation of ganglionated plexi (GP) may be considered. This meta-analysis aimed to evaluate the efficacy of GP catheter ablation in pat...

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Main Authors: Alexandru Ababei, Cosmin Gabriel Ursu, Mircea Ioan Alexandru Bistriceanu, Darie Ioan Andreescu, Iasmina-Maria Iurea, Beatrice Budeanu, Adriana Elena Dumitrache, Alexandra Hostiuc, Maria-Celina Sturz-Lazar, Cristian-Valentin Toma, Stefan Sebastian Busnatu, Alexandru Deaconu, Stefan Bogdan
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Biomedicines
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Online Access:https://www.mdpi.com/2227-9059/13/7/1758
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author Alexandru Ababei
Cosmin Gabriel Ursu
Mircea Ioan Alexandru Bistriceanu
Darie Ioan Andreescu
Iasmina-Maria Iurea
Beatrice Budeanu
Adriana Elena Dumitrache
Alexandra Hostiuc
Maria-Celina Sturz-Lazar
Cristian-Valentin Toma
Stefan Sebastian Busnatu
Alexandru Deaconu
Stefan Bogdan
author_facet Alexandru Ababei
Cosmin Gabriel Ursu
Mircea Ioan Alexandru Bistriceanu
Darie Ioan Andreescu
Iasmina-Maria Iurea
Beatrice Budeanu
Adriana Elena Dumitrache
Alexandra Hostiuc
Maria-Celina Sturz-Lazar
Cristian-Valentin Toma
Stefan Sebastian Busnatu
Alexandru Deaconu
Stefan Bogdan
author_sort Alexandru Ababei
collection DOAJ
description <b>Background:</b> When conservative therapies are insufficient for vasovagal syncope (VVS), procedural options such as permanent pacemakers or catheter ablation of ganglionated plexi (GP) may be considered. This meta-analysis aimed to evaluate the efficacy of GP catheter ablation in patients with VVS. <b>Methods:</b> A comprehensive literature search was performed in PubMed, Embase, and the Cochrane Library from 15 March 2024 to 10 May 2025. After duplicate removal, two reviewers independently screened studies and assessed full texts based on predefined criteria. A single-arm proportion meta-analysis was conducted. <b>Results:</b> Thirty-seven studies comprising 1585 participants were included. The pooled proportion of VVS recurrence after ablation was 8.9% (95% CI, 6.4–11.4%), but with substantial heterogeneity (I<sup>2</sup> = 74.4%, <i>p</i> < 0.001). Sensitivity and subgroup analyses confirmed the robustness of the pooled estimate. A meta-regression was performed to further explore potential effect modifiers, but no covariate reached statistical significance. <b>Conclusions:</b> This meta-analysis suggests that ganglionated plexi catheter ablation may be associated with a reduced recurrence of vasovagal syncope in selected populations. However, the findings are based predominantly on non-randomized observational studies, and the high between-study heterogeneity limits the strength of inference. Future randomized controlled trials with standardized methodologies are needed to confirm the long-term efficacy and safety of this intervention.
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spelling doaj-art-caf162d6534c4b7bbfb0a05674629bd82025-08-20T03:36:34ZengMDPI AGBiomedicines2227-90592025-07-01137175810.3390/biomedicines13071758Cardioneuroablation for Vasovagal Syncope: An Updated Systematic Review and Single-Arm Meta-AnalysisAlexandru Ababei0Cosmin Gabriel Ursu1Mircea Ioan Alexandru Bistriceanu2Darie Ioan Andreescu3Iasmina-Maria Iurea4Beatrice Budeanu5Adriana Elena Dumitrache6Alexandra Hostiuc7Maria-Celina Sturz-Lazar8Cristian-Valentin Toma9Stefan Sebastian Busnatu10Alexandru Deaconu11Stefan Bogdan12Iliescu Emergency Institute for Cardiovascular Diseases, 022328 Bucharest, RomaniaFaculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaFaculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaFaculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaFaculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaFaculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaFaculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaFaculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaFaculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaFaculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaFaculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaFaculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaFaculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania<b>Background:</b> When conservative therapies are insufficient for vasovagal syncope (VVS), procedural options such as permanent pacemakers or catheter ablation of ganglionated plexi (GP) may be considered. This meta-analysis aimed to evaluate the efficacy of GP catheter ablation in patients with VVS. <b>Methods:</b> A comprehensive literature search was performed in PubMed, Embase, and the Cochrane Library from 15 March 2024 to 10 May 2025. After duplicate removal, two reviewers independently screened studies and assessed full texts based on predefined criteria. A single-arm proportion meta-analysis was conducted. <b>Results:</b> Thirty-seven studies comprising 1585 participants were included. The pooled proportion of VVS recurrence after ablation was 8.9% (95% CI, 6.4–11.4%), but with substantial heterogeneity (I<sup>2</sup> = 74.4%, <i>p</i> < 0.001). Sensitivity and subgroup analyses confirmed the robustness of the pooled estimate. A meta-regression was performed to further explore potential effect modifiers, but no covariate reached statistical significance. <b>Conclusions:</b> This meta-analysis suggests that ganglionated plexi catheter ablation may be associated with a reduced recurrence of vasovagal syncope in selected populations. However, the findings are based predominantly on non-randomized observational studies, and the high between-study heterogeneity limits the strength of inference. Future randomized controlled trials with standardized methodologies are needed to confirm the long-term efficacy and safety of this intervention.https://www.mdpi.com/2227-9059/13/7/1758vasovagal syncopecardioneuroablationganglionated plexus
spellingShingle Alexandru Ababei
Cosmin Gabriel Ursu
Mircea Ioan Alexandru Bistriceanu
Darie Ioan Andreescu
Iasmina-Maria Iurea
Beatrice Budeanu
Adriana Elena Dumitrache
Alexandra Hostiuc
Maria-Celina Sturz-Lazar
Cristian-Valentin Toma
Stefan Sebastian Busnatu
Alexandru Deaconu
Stefan Bogdan
Cardioneuroablation for Vasovagal Syncope: An Updated Systematic Review and Single-Arm Meta-Analysis
Biomedicines
vasovagal syncope
cardioneuroablation
ganglionated plexus
title Cardioneuroablation for Vasovagal Syncope: An Updated Systematic Review and Single-Arm Meta-Analysis
title_full Cardioneuroablation for Vasovagal Syncope: An Updated Systematic Review and Single-Arm Meta-Analysis
title_fullStr Cardioneuroablation for Vasovagal Syncope: An Updated Systematic Review and Single-Arm Meta-Analysis
title_full_unstemmed Cardioneuroablation for Vasovagal Syncope: An Updated Systematic Review and Single-Arm Meta-Analysis
title_short Cardioneuroablation for Vasovagal Syncope: An Updated Systematic Review and Single-Arm Meta-Analysis
title_sort cardioneuroablation for vasovagal syncope an updated systematic review and single arm meta analysis
topic vasovagal syncope
cardioneuroablation
ganglionated plexus
url https://www.mdpi.com/2227-9059/13/7/1758
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