期刊
CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY
卷 5, 期 4, 页码 782-788出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/CIRCEP.112.971754
关键词
catecholaminergic polymorphic ventricular tachycardia; sudden cardiac arrest; ventricular fibrillation; left cardiac sympathetic denervation; denervation
资金
- National Institutes of Health (NIH)/National Center for Research Resources CTSA Grant [UL1 RR024150]
Background-Treatment options for patients with recurrent ventricular arrhythmias refractory to pharmacotherapy and ablation are minimal. Although left cardiac sympathetic denervation (LCSD) is well established in long-QT syndrome, its role in non-long-QT syndrome arrhythmogenic channelopathies and cardiomyopathies is less clear. Here, we report our single-center experience in performing LCSD in this setting. Methods and Results-In this institutional review board-approved study, we retrospectively reviewed the electronic medical records of all patients (N=91) who had videoscopic LCSD at our institution from 2005 to 2011. Data were analyzed for the subset (n=27) who were denervated for an underlying diagnosis other than autosomal dominant or sporadic long-QT syndrome. The spectrum of arrhythmogenic disease included catecholaminergic polymorphic ventricular tachycardia (n=13), Jervell and Lange-Nielsen syndrome (n=5), idiopathic ventricular fibrillation (n=4), left ventricular noncompaction (n=2), hypertrophic cardiomyopathy (n=1), ischemic cardiomyopathy (n=1), and arrhythmogenic right ventricular cardiomyopathy (n=1). Five patients had LCSD because of high-risk assessment and beta-blocker intolerance, none of whom had a sentinel breakthrough cardiac event at early follow-up. Among the remaining 22 previously symptomatic patients who had LCSD as secondary prevention, all had an attenuation in cardiac events, with 18 having no breakthrough cardiac events so far and 4 having experienced >= 1 post-LCSD breakthrough cardiac event. Conclusions-LCSD may represent a substrate-independent antifibrillatory treatment option for patients with life-threatening ventricular arrhythmia syndromes other than long-QT syndrome. The early follow-up seems promising, with a marked reduction in the frequency of cardiac events postdenervation. (Circ Arrhythm Electrophysiol. 2012;5:782-788.)
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