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

被引:1
作者
Lampridis, Savvas [1 ]
Antonopoulos, Achilleas [1 ]
Kakos, Christos [1 ]
Mitsos, Sofoklis [1 ]
Patrini, Davide [1 ]
Lawrence, David R. [1 ]
Panagiotopoulos, Nikolaos [1 ]
机构
[1] Univ Coll London Hosp NHS Fdn Trust, Dept Thorac Surg, London, England
关键词
Defibrillators; implantable; genotype; long QT syndrome; sympathectomy; tachycardia; ventricular; thoracic surgery; video-assisted; MANAGEMENT; INTERVAL;
D O I
10.1177/0218492320971492
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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. 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. 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). 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.
引用
收藏
页码:186 / 190
页数:5
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