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Bilateral sympathectomy for treatment of refractory ventricular tachycardia
Author(s) -
Kopecky Kathleen,
Afzal Aasim,
Felius Joost,
Hall Shelley A.,
Mendez Jose C.,
Assar Manish,
Mason David P.,
Bindra Amarinder S.
Publication year - 2018
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.13164
Subject(s) - medicine , cardiology , sympathectomy , refractory (planetary science) , ventricular tachycardia , implantable cardioverter defibrillator , sympathetic denervation , cardiomyopathy , tachycardia , ablation , ventricular fibrillation , ischemic cardiomyopathy , anesthesia , heart failure , denervation , ejection fraction , physics , astrobiology
Ventricular tachycardia (VT) commonly occurs in patients with ischemic or nonischemic cardiomyopathy and requires antiarrhythmic drugs, ablation, or advanced circulatory support. However, life‐threatening VT may be refractory to these therapies, and may cause frequent implantable cardioverter defibrillator (ICD) discharges. Left cardiac sympathetic denervation reduces the occurrence of these fatal arrhythmias by inhibiting the sympathetic outflow to the cardiac tissue. We present a 69‐year‐old man with nonischemic cardiomyopathy, life‐threatening VT, and hemodynamic instability with numerous ICD discharges, who remained refractory to antiarrhythmic drug therapy and ablation attempts. He was effectively treated with bilateral cardiac sympathectomy. Six months later, he remained free of VT with no ICD discharges.