Outcomes following cardiac sympathetic denervation in patients with structural heart disease and refractory ventricular arrhythmia

• DOI: 10.1093/europace/euac078
• Publication Date: 2022-05-10T11:20:06Z
• Authors: Sebastian König; Thomas Schröter; Michael A Borger; Livio Bertagnolli; Sotirios Nedios; Angeliki Darma; Gerhard Hindricks; Arash Arya; Borislav Dinov
• Keywords: Refractory (planetary science)

Abstract Aim Cardiac sympathetic denervation (CSD) has been introduced as a bailout therapy in patients with structural heart disease and refractory ventricular arrhythmias (VAs), but available data are scarce. Purpose of this study was to estimate immediate results, complications, mid-term outcomes CSD following recurrent VA after catheter ablation. Methods results Adult who underwent the Heart Center Leipzig from March 2017 February 2021 were retrospectively analysed. Follow-up (FU) executed via implantable cardioverter defibrillator (ICD) interrogation, telephone interviews, reviewing medical records. Twenty-one (age 63.7 ± 14.4 years, all men, 71.4% non-ischaemic cardiomyopathy, left ejection fraction 31.6 12.6%) received video-assisted thoracoscopic surgery (90.5% bilateral, 9.5% left-sided only). Indication for monomorphic tachycardia 76.2% fibrillation 23.8 presenting electrical storm before index hospitalization. Procedure-related major complications occurred patients. In-hospital adverse events not related common (28.6%) two died during hospital stay. During FU (mean duration 9.1 6.5 months), five more died. Of remaining patients, 38.5 76.9% free any or ICD shocks, respectively. Conclusions The showed additional moderate efficacy suppress VAs, when performed previously unsuccessful At 9 months, it associated freedom shocks two-thirds In population many comorbidities, rate CSD-related acceptable, although there an overall high risk procedure unrelated death.