Frequent neurally mediated reflex syncope in a young patient with dextrocardia: Efficacy of catheter ablation of the superior vena cava–aorta ganglionated plexus

Neurally mediated reflex syncope is the most common cause of syncope in young individuals without cardiac or neurological pathology. We report a case of successful catheter ablation in a 17-year-old male with neurally mediated syncope (NMS) of the cardioinhibitory type. The patient had dextrocardia situs inversus totalis with a mirror-image reversal of the thoracic and abdominal organs. Because he experienced multiple syncope episodes despite pharmacological intervention, we performed endocardial ablation of the superior vena cava–aorta ganglionated plexus. Shortly afterwards, his heart rate increased from 40 to 76 beats per minutes. He has not experienced syncope during the 1-year follow-up.