Response by Rivarola and Scanavacca to Letter Regarding Article, “Targets and End Points in Cardiac Autonomic Denervation Procedures”
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We would like to thank Drs Pachón-Mateos and Pachón-Mateos for their interesting remarks on the article, Targets and End Points in Cardiac Autonomic Denervation Procedures1 and Editorial, Selective Modulation of the Cardiac Autonomic Nervous System: A New Strategy for Treatment of Cardioinhibitory Syncope.2 In his letter, Dr Pachón-Mateos raises important questions about the mapping technique and denervation end points and proposes that
cardioneuroablation must be validated by extracardiac vagal stimulation;
preablation atropine test must be used to identify responders;
specific mapping technique should be performed to guide ablation;
extensive ablation, including pulmonary veins antra, is needed.
In our opinion, the clinical limitations of the …