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Cardiac sympathetic denervation for refractory ventricular arrhythmias in patients with structural heart disease: A systematic review
- Source :
- Heart Rhythm. 16:1499-1505
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- Background Cardiac sympathetic denervation (CSD) is an important adjunctive option for patients with refractory ventricular arrhythmias (VAs). Reports of efficacy of CSD in patients with structural heart disease (SHD) and refractory VA vary widely in literature. Objective The purpose of this study was to conduct a systematic review of arrhythmic outcomes and complications in patients with SHD who underwent CSD due to recurrent VAs. Methods Electronic databases (Google Scholar and PubMed) were searched to identify reports on CSD in SHD using appropriate medical subject terms. No sample size restriction was applied. All patients with known channelopathies were excluded. Baseline demographic and surgical data, arrhythmic outcomes, and procedural complications were evaluated. Results A total of 13 studies and 173 patients were included. Of the 173 patients (121 [70%] male); pooled mean age 54.6 [95% confidence interval 52.6–56.7] years), 48 (28%) had ischemic cardiomyopathy, and 141 (82%) underwent bilateral CSD. Overall freedom from events ranged from 58% to 100%. Complications were reported in 49 patients(28%). Transient hypotension (9%), pneumothorax (5%), neuropathic pain (skin sensitivity) (4%), Horner syndrome (3%), sweating pattern changes (3%), and hemothorax (2%) were the most common complications. No procedure-related deaths were reported. Conclusion CSD reduced the number of VA events in patients with SHD, and the benefit from the intervention seemed to be independent of the underlying SHD. Although overall rate of postprocedural complications was high, most of the complications were temporary. Major postprocedural complications after CSD were infrequent.
- Subjects :
- Male
medicine.medical_specialty
Heart Diseases
Heart disease
Horner syndrome
Comorbidity
030204 cardiovascular system & hematology
Risk Assessment
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Refractory
Recurrence
Physiology (medical)
Internal medicine
Humans
Medicine
030212 general & internal medicine
Sympathectomy
Aged
Ischemic cardiomyopathy
business.industry
Middle Aged
Prognosis
Hemothorax
medicine.disease
Confidence interval
Survival Rate
Treatment Outcome
Pneumothorax
Neuropathic pain
Tachycardia, Ventricular
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 15475271
- Volume :
- 16
- Database :
- OpenAIRE
- Journal :
- Heart Rhythm
- Accession number :
- edsair.doi.dedup.....6bb77e1605e8ecbfc9cb7f558959bb4a