Cardioneuroablation for 2:1 AV Block: A Pacemaker Alternative

Dr Amr Nawar (Sultal Qaboos Hospital, Seeb, OM) presents a case-based exploration of cardioneuroablation (CNA), walking through its use as an alternative to permanent pacing in a young patient with recurrent symptomatic atrioventricular block who declined a device. The case centres on a 42-year-old man referred for pacing following recurrent near-syncope and exercise intolerance, in whom Holter monitoring revealed frequent intermittent 2:1 heart block. After he firmly declined pacemaker implantation, CNA was offered and undertaken. Dr Nawar uses the case to ground a wider discussion of cardiac autonomic anatomy, patient selection, mapping of the ganglionated plexi, procedural endpoints and follow-up, illustrating where CNA may fit in the management of reflex and functional bradyarrhythmias. Support: This is an independent case presentation produced by Radcliffe Cardiology.