First bipolar selective cardioneuroablation in symptomatic sinus node dysfunction -- a case report

In recent years cardioneuroablation has emerged as a novel therapeutic option for bradyarrhythmias, which can avoid necessity for pacemaker implantation. Main assumption of cardioneuroablation is that destroying epicardially located neural bodies of parasympathetic postganglionic neurons by endocardial radiofrequency ablation would permanently increase sinus rhythm. In some cases unipolar radiofrequency ablation might damage only neural fibers and clinical effect of the procedure might be transient due to subsequent reinnervation. Bipolar ablation can create deeper, transmural and durable lesions. This property seems promising as a method to overcome possible disadvantage of unipolar cardioneuroablation. To our knowledge, we present first bipolar cardioneuroablation.