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Clinical Research in Cardiology

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Open Access 01-01-2013 | Original Paper

Left cardiac sympathetic denervation for the management of life-threatening ventricular tachyarrhythmias in young patients with catecholaminergic polymorphic ventricular tachycardia and long QT syndrome

Authors: Heike E. Schneider, Michael Steinmetz, Ulrich Krause, Thomas Kriebel, Wolfgang Ruschewski, Thomas Paul

Published in: Clinical Research in Cardiology | Issue 1/2013

Abstract

Background

Left cardiac sympathetic denervation (LCSD) may be a therapeutic adjunct for young patients with catecholaminergic polymorphic ventricular tachycardia (CPVT) and long QT syndrome (LQTS) who are not fully protected by beta-blockade.

Objective

The objective of this analysis was to report our institutional experience with LSCD in young patients for the management of life-threatening ventricular arrhythmias in CPVT and LQTS.

Methods

Ten young patients with CPVT and LQTS underwent transaxillary LSCD at our institution. Mean age at surgery was 14.0 (range 3.9–42) years, mean body weight was 45.7 (range 15.5–90) kg. Five patients had the clinical diagnosis of CPVT, three were genotype positive for a mutation in the ryanodine-receptor-2-gene. Four of five LQTS patients were genotype positive. Indications for LCSD were recurrent syncope, symptomatic episodes of ventricular tachycardias and/or internal cardioverter–defibrillator (ICD) discharges, and aborted cardiac arrest despite high doses of beta-blockers.

Results

LCSD was performed via the transaxillary approach. No significant complications were observed. Two patients already had an ICD, 6 patients received an ICD at the same operation or shortly thereafter. Median length of follow-up after LCSD was 2.3 (range 0.6–3.9) years. After LCSD a marked reduction in arrhythmia burden and cardiac events was observed in all patients while medication was continued. None of the patients had any further ICD discharge for sustained VT.

Conclusions

After LCSD, arrhythmia burden could significantly be reduced in all our young patients with CPVT and LQTS.

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Title: Left cardiac sympathetic denervation for the management of life-threatening ventricular tachyarrhythmias in young patients with catecholaminergic polymorphic ventricular tachycardia and long QT syndrome
Authors: Heike E. Schneider
Michael Steinmetz
Ulrich Krause
Thomas Kriebel
Wolfgang Ruschewski
Thomas Paul
Publication date: 01-01-2013
Publisher: Springer-Verlag
Published in: Clinical Research in Cardiology / Issue 1/2013
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-012-0492-7

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Left cardiac sympathetic denervation for the management of life-threatening ventricular tachyarrhythmias in young patients with catecholaminergic polymorphic ventricular tachycardia and long QT syndrome

Abstract

Background

Objective

Methods

Results

Conclusions

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Abstract

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Conclusions

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