Long‐term clinical outcomes of cardiac sympathetic denervation in patients with refractory ventricular arrhythmias

• Published in: Journal of cardiovascular electrophysiology 2021-04, Vol.32 (4), p.1065-1074
• Main Authors: Barwad, Parag, Sinkar, Kunal, Bachani, Neeta, Shah, Rushil, Shah, Vihang, Kumar, Binay, Bhoskar, Shrikant, Desai, Neeraj, Lokhandwala, Yash
• Format: Article
• Language: English
• Subjects: Arrhythmia; cardiac sympathectomy; Cardiovascular disease; cardioversion; Catheters; Clinical outcomes; Coronary artery disease; Defibrillators; Denervation; electrical storm; Heart diseases; Ischemia; Patients; Tachycardia; Ventricle; ventricular tachycardia
• ISSN: 1045-3873; 1540-8167
• DOI: 10.1111/jce.14947

Background Cardiac sympathetic denervation (CSD) is a useful therapeutic option in patients with structural heart disease (SHD) and ventricular tachycardia (VT) who are otherwise refractory to standard antiarrhythmic drug (AAD) therapy or catheter ablation (CA). In this study, we sought to retrospectively analyze the long‐term outcomes of CSD in patients with refractory VT and/or VT storm with a majority of the patients being taken up for CSD ahead of CA. Methods We included consecutive patients with SHD who underwent CBD from 2010 to 2019 owing to refractory VT. A complete response to CSD was defined as a greater than 75% reduction in the frequency of ICD shocks for VT. Results A total of 65 patients (50 male, 15 female) were included. The underlying VT substrate was ischemic heart disease (IHD) in 30 (46.2%) patients while the remaining 35 (53.8%) patients had other nonischemic causes. The mean duration of follow‐up was 27 ± 24 months. A complete response to CSD was achieved in 47 (72.3%) patients. There was a significant decline in the number of implantable cardioverter‐defibrillator (ICD) or external defibrillator shocks post‐CSD (24 ± 37 vs. 2 ± 4, p