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Video‐Assisted Thoracoscopic Left Cardiac Sympathetic Denervation in Patients with Hereditary Ventricular Arrhythmias
Author(s) -
JANG SE YONG,
CHO YONGKEUN,
KIM NAM KYUN,
KIM CHANGYEON,
SOHN JIHYUN,
ROH JAEHYUNG,
BAE MYUNG HWAN,
LEE JANG HOON,
YANG DONG HEON,
PARK HUN SIK,
CHAE SHUNG CHULL,
OH TAKHYUK,
KIM GUN JIK
Publication year - 2017
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.13008
Subject(s) - medicine , catecholaminergic polymorphic ventricular tachycardia , sympathetic denervation , long qt syndrome , cardiology , torsades de pointes , ventricular tachycardia , implantable cardioverter defibrillator , qt interval , anesthesia , ryanodine receptor 2 , denervation , ryanodine receptor , calcium
Background Left cardiac sympathetic denervation (LCSD) has been underutilized in patients with hereditary ventricular arrhythmia syndromes such as congenital long QT syndrome (LQTS) and catecholaminergic polymorphic ventricular tachycardia (CPVT). The purpose of this study was to investigate the safety and efficacy of video‐assisted thoracoscopic (VATS) LCSD in such patients. Methods Fifteen patients (four men, 24.6 ± 10.5 years old) who underwent VATS‐LCSD between November 2010 and January 2015 for hereditary ventricular arrhythmia syndromes at Kyungpook National University Hospital were enrolled in this study. The safety and efficacy of VATS‐LCSD were evaluated by periprocedural epinephrine tests and assessing the development of complications and cardiac events during follow‐up. Results Fourteen patients with LQTS and one patient with CPVT underwent VATS‐LCSD. Six and one patients developed ventricular tachyarrhythmia during preprocedural and postprocedural epinephrine test, respectively (P = 0.063). No serious complications such as Horner syndrome, pneumothorax, or bleeding developed after LCSD. Mean hospital stay after VATS‐LCSD was 3.7 ± 1.5 days. During a mean follow‐up of 927 ± 350 days, one LQTS patient and one CPVT patient, neither of whom manifested tachyarrhythmia during post‐LCSD epinephrine test, developed torsades de pointes and syncope, respectively. The annual event rates of six patients who were symptomatic during the period preceding LCSD decreased from 0.97 to 0.19 events/year (P = 0.045). Conclusions VATS‐LCSD was a safe, and effective procedure for patients with hereditary ventricular tachycardia syndrome, with no serious adverse events and with short hospital stay.