Comparison of the Efficacy and Safety of Cardioneuroablation to Permanent Pacing in Patients With an Implanted Pacemaker for Symptomatic Bradycardia.

Visit 1- Screening, recruitment, randomization. * ECG, PM check, NIEPS * change the stimulation mode to DDD 50/min, AV 220ms/ VVI 50/min/ AAI 50/min * atropine test * laboratory tests: complete blood count, creatinine, AST, ALT, TSH, fT3, fT4, NT-proBNP, beta-HCG, K * analysis of inclusion and exclusion criteria Hospitalization 1-1 month from randomization Group 1- EPS, ECVS, CNA, ILR implantation Group 2- EPS, ECVS, ILR implantation Group 3- observation Visit 2-3 months after randomization Group 1 and 2: * History of MAS and paraMAS symptoms and the consequences of the procedures performed. * PM control with the assessment of the percentage of stimulation. Change settings and check PM - to assess the efficiency of own rhythm, patients will then have their pacemaker reprogrammed in DDD 50/min mode with AV 220ms or VVI 50/min. or AAI 50/min. * ECG * NIEPS * 24-hour Holter ECG monitoring * ILR control Group 3 observation: * History of MAS and paraMAS symptoms. * PM control with the assessment of the percentage of stimulation. Hospitalization 2-4 months from randomization Group 1 - EPS, ECVS, redo CNA if required Group 2 - EPS, ECVS, CNA Group 1 and 2 patients will have their pacemaker set to VVI/AAI 30/min. For patients of Groups 1 and 2 in whom the CNA proved to be ineffective, the PM will be programmed in the optimal mode for them. Visit 3-6 months after randomization Group 1 and 2: * History of MAS and paraMAS symptoms and the consequences of the procedures performed. * PM control with the evaluation of the percentage of stimulation. Changing settings and checking PM- to assess the efficiency of your own rhythm * ECG * NIEPS * 24 hour Holter ECG monitoring * ILR control Patients from groups 1 and 2, whose percentage of stimulation in PM control will be 0%, will have their PM reprogrammed to ODO/OVO/OAO - pacing off. Group 3 observation: * History of MAS and paraMAS symptoms. * PM control with the assessment of the percentage of stimulation. Visits 4, 5, 6 - consecutively 9, 12, 15 months after randomization Groups 1 and 2: * Anamnesis for possible symptoms of bradycardia and undesirable effects of the procedure. * PM control * ECG * NIEPS * 24-hour Holter ECG monitoring * ILR control Patients in Groups 1 and 2 who experience symptoms of bradycardia correlated with bradycardia recorded in the ILR will resume pacing in the optimal mode for them. During these visits, patients in Group 3 and Groups 1 and 2 who had their pacing restored/optimized will be interviewed for possible MAS and paraMAS symptoms, perform a physical examination, and check the PM with assessment of pacing percentage and pacing mode optimization. Visit 7 - ending the study - 18 months from randomization. Group 1 and 2: * Anamnesis for possible symptoms of bradycardia and undesirable effects of the procedure. * PM control * ECG * NIEPS * Atropine test * 24-hour Holter ECG monitoring * ILR control Patients from groups 1 and 2 without symptoms of bradycardia and without asymptomatic bradycardia \<40/min recorded in the ILR, after assessment by the EP-HEART TEAM (a council of two cardiologist specialists), will be qualified for the end of permanent pacing therapy. Those patients with a low risk of TLE will be qualified for TLE. During this visit, Group 3 and Group 1 and 2 patients with previously pacing restored/optimized will be interviewed for possible MAS and paraMAS symptoms, perform a physical examination and PM check with assessment of pacing percentage and pacing mode optimisation. The ILR will be left in place until the battery runs out or will be removed sooner at the patient's request.