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Video-thoracoscopic left cardiac sympathetic denervation for long-QT syndrome.

Authors :
Lampridis S
Antonopoulos A
Kakos C
Mitsos S
Patrini D
Lawrence DR
Panagiotopoulos N
Source :
Asian cardiovascular & thoracic annals [Asian Cardiovasc Thorac Ann] 2021 Mar; Vol. 29 (3), pp. 186-190. Date of Electronic Publication: 2020 Oct 28.
Publication Year :
2021

Abstract

Background: Congenital long-QT syndrome represents the most common cardiac channelopathy and manifests as potentially lethal ventricular arrhythmias. Prevention strategies include beta-blockade pharmacotherapy, implantable cardioverter-defibrillators, and left cardiac sympathetic denervation, which can increase the threshold for ventricular fibrillation. Herein, we report our experience with video-assisted thoracoscopic left cardiac sympathetic denervation.<br />Methods: We performed a retrospective review of the electronic medical records of all patients with congenital long-QT syndrome who underwent video-assisted thoracoscopic left cardiac sympathetic denervation at our institution.<br />Results: From September 2009 to May 2016, 6 patients with a mean age of 30.5 years (range 20-47 years) underwent video-assisted thoracoscopic left cardiac sympathetic denervation for medically refractory long-QT syndrome. All patients had an uneventful recovery and were discharged 1-3 days after the operation. At a median follow-up of 14 months (range 12-60 months), 4 patients had no cardiac events while 2 experienced 1 episode of arrhythmic syncope and 1 episode of appropriate implantable cardioverter-defibrillator shock. Following surgery, the mean annual cardiac events in the study cohort decreased from 2.13 to 0.33 ( p  = 0.004) and the mean corrected QT interval reduced from 560 ms to 491 ms ( p  = 0.006).<br />Conclusions: Video-assisted thoracoscopic left cardiac sympathetic denervation is a safe and effective therapy in patients with congenital long-QT syndrome who continue to suffer from recurrent life-threatening arrhythmias or frequent implantable cardioverter-defibrillator discharges despite maximum tolerated doses of beta blockers.

Details

Language :
English
ISSN :
1816-5370
Volume :
29
Issue :
3
Database :
MEDLINE
Journal :
Asian cardiovascular & thoracic annals
Publication Type :
Academic Journal
Accession number :
33115260
Full Text :
https://doi.org/10.1177/0218492320971492