Peak Frequency-Guided Cardioneuroablation and Pulmonary Vein Isolation in Sinus Node Dysfunction and Atrial Fibrillation.

ABSTRACT:

Background

Sinus node dysfunction (SND) commonly coexists with atrial fibrillation (AF), leading to bradycardia, syncope, and pacemaker implantation. Effective therapies addressing both arrhythmic triggers and autonomic factors remain limited.

Case summary

A 49-year-old woman with paroxysmal AF, symptomatic sinus bradycardia, and frequent sinus pauses showed prolonged sinus node recovery time. High-resolution electroanatomic mapping with peak frequency analysis identified fractionated, high-frequency atrial potentials in the anterior right superior pulmonary vein. Selective cardioneuroablation and pulmonary vein isolation normalized heart rate, improved recovery time, and maintained sinus rhythm without pacemaker implantation over 12 months.

Discussion

This case illus

SUBMITTER: Sobue Y 

PROVIDER: S-EPMC12802632 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature