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RecruitingNCT06166277CNA-FWRDUpdated Sep 18, 2025

Cardioneuroablation for Recurrent Vasovagal Syncope and Bradyarrhythmias: The CNA-FWRD Registry

An observational study in Vasovagal Syncope, AV Block-2Nd Degree-Type 1 and Sinus Pause, sponsored by Rush University Medical Center. Recruiting at 1 site in United States. Open to participants aged 18 Years to 60 Years. Per ClinicalTrials.gov, last updated 2025-09-18.

Sponsored by Rush University Medical Center · Observational

Study type
Observational
Model
Case-crossover
Time perspective
Prospective
Enrollment
300
Ages
18 Years to 60 Years
Sex
All
01

Study summary

The CNA-FWRD Registry is an international prospective observational multicenter registry of patients with symptomatic vasovagal syncope and bradyarrhythmias managed under routine care by medical therapy and radiofrequency catheter ablation of ganglionated plexi or permanent pacemaker implantation.

Read the detailed description

The CNA-FWRD Registry is an international prospective observational multicenter registry of patients with symptomatic vasovagal syncope and bradyarrhythmias managed under routine care by medical therapy and radiofrequency catheter ablation of ganglionated plexi or permanent pacemaker implantation. Major inclusion criteria for enrollment are history of VVS or symptomatic bradyarrhythmia, age \< 60 years, and evaluation by a physician and discussion about potential candidacy for radiofrequency cardioneuroablation or permanent pacemaker implantation for medically refractory symptoms.

For analysis purposes, patients awaiting the intervention will remain in the "control group" and will cross-over to the "procedural group" after successful completion of radiofrequency cardioneuroablation procedure. The follow-up for the procedure group will start at completion of CNA procedure, but patients who eventually do not get the procedure will stay in the control group until the end of the study, with similar follow-up performed as for the patients undergoing RFCA procedure. If a patient in the control group undergoes permanent pacemaker placement, then the day after the procedure the patient will be removed from the control group for follow up.

02

Conditions studied

  • Vasovagal Syncope
  • AV Block-2Nd Degree-Type 1
  • Sinus Pause

Keywords

  • vasovagal syncope
  • av block
  • sinus pause
  • pacemaker
  • cardioneuroablation
  • radiofrequency ablation
03

Who can participate

Ages eligible
18 Years to 60 Years
Sexes eligible
All
Sampling method
Non-probability sample

Study population

Patients with vasovagal syncope or symptomatic bradyarrhythmia

Inclusion criteria

  • symptomatic vasovagal syncope or symptomatic bradyarrhythmia refractory to behavioral and medical measures
  • age \< 60 years

Exclusion criteria

Exclusion Criteria:

  • age > 60 years
  • intra-/infra-Hisian AV block
  • intrinsic sinus node disease
  • history of supraventricular tachycardia
  • history of ventricular tachycardia
  • presence of structural heart disease related
  • prior history of catheter ablation
  • presence of inheritable arrhythmic conditions
  • orthostatic hypotension on HUTT test
  • abnormal thyroid function levels
  • Proven indication for permanent pacemaker implantation
04

Study design

Observational model
Case-crossover
Time perspective
Prospective
Enrollment
300 participants (estimated)
Target follow-up
3 Years
Patient registry
Yes

Groups and cohorts

  • Control group

    Awaiting the intervention, medically managed patients will remain in the control group for analysis purposes

  • Procedural group

    After undergoing successful radiofrequency cardioneuroablation or permanent pacemaker procedures the patient will cross-over to the procedural group for analysis purposes

    Procedure: Ablation procedure

Interventions

  • ProcedureAblation procedure

    Cardioneuroablation procedure or permanent pacemaker placement

    Also known as: Permanent pacemaker placement

05

What researchers measure

Primary outcomes

  1. Syncope

    Recurrent syncope

    Time frame: 3 years

Secondary outcomes

  1. Time to first syncopal recurrence

    Time to first syncope episode since enrollment

    Time frame: 3 years

  2. Syncope burden

    Number of syncopal episodes

    Time frame: 3 years

  3. Presyncope burden

    Number of pre syncopal episodes

    Time frame: 3 years

  4. Ablation induced change in heart rate

    Delta change in HR between pre-ablation and post-ablation

    Time frame: 1 year

  5. Complications associated with GP ablation

    Major peri-procedural complications

    Time frame: 1 year

  6. Quality of life before and 12 months after ablation

    QoL assessed by survey

    Time frame: 1 year

  7. Redo-ablation procedures

    Redo-ablation procedures for primary outcomes

    Time frame: 3 years

  8. Atrial arrhythmias

    Development of new atrial arrhythmias

    Time frame: 3 years

06

Study locations

1 of 1 sites recruiting
  • Rush University Medical Centert
    Chicago, Illinois 60657, United States
    Recruiting
07

References and documents

Publications

  • Pachon JC, Pachon EI, Pachon JC, Lobo TJ, Pachon MZ, Vargas RN, Jatene AD. "Cardioneuroablation"--new treatment for neurocardiogenic syncope, functional AV block and sinus dysfunction using catheter RF-ablation. Europace. 2005 Jan;7(1):1-13. doi: 10.1016/j.eupc.2004.10.003. PubMed 15670960 ↗
  • Pachon JC, Pachon EI, Cunha Pachon MZ, Lobo TJ, Pachon JC, Santillana TG. Catheter ablation of severe neurally meditated reflex (neurocardiogenic or vasovagal) syncope: cardioneuroablation long-term results. Europace. 2011 Sep;13(9):1231-42. doi: 10.1093/europace/eur163. Epub 2011 Jun 28. PubMed 21712276 ↗
  • Scanavacca M, Hachul D. Ganglionated Plexi Ablation to Treat Patients with Refractory Neurally Mediated Syncope and Severe Vagal-Induced Bradycardia. Arq Bras Cardiol. 2019 Jul 15;112(6):709-712. doi: 10.5935/abc.20190107. No abstract available. PubMed 31314822 ↗
  • Aksu T, Gopinathannair R, Bozyel S, Yalin K, Gupta D. Cardioneuroablation for Treatment of Atrioventricular Block. Circ Arrhythm Electrophysiol. 2021 Sep;14(9):e010018. doi: 10.1161/CIRCEP.121.010018. Epub 2021 Sep 1. PubMed 34465122 ↗
  • Piotrowski R, Baran J, Sikorska A, Krynski T, Kulakowski P. Cardioneuroablation for Reflex Syncope: Efficacy and Effects on Autonomic Cardiac Regulation-A Prospective Randomized Trial. JACC Clin Electrophysiol. 2023 Jan;9(1):85-95. doi: 10.1016/j.jacep.2022.08.011. Epub 2022 Aug 28. PubMed 36114133 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT06166277
Lead sponsor
Rush University Medical Center
Responsible party
Sponsor
First posted
Dec 12, 2023
Start date
Aug 1, 2024
Primary completion
Dec 31, 2026 (estimated)
Completion
Apr 30, 2027 (estimated)
Last update
Sep 18, 2025

Study contacts

Alexander Mazur, MD
Contact
alexander_mazur@rush.edu
312-942-5020
Jeanne du Fay de Lavallaz, MD
Contact
jeanne.dufaydelavallaz@gmail.com
312-942-5000
Tolga Aksu, MD
study chair · Yepedite University

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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