Journal of Chest Surgery

  • 제56권6호
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  • Pages.414-419
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  • 2023
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  • 2765-1606(pISSN)
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  • 2765-1614(eISSN)
대한심장혈관흉부외과학회 (The Korean Society for Thoracic and Cardiovascular Surgery)
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Bilateral Cardiac Sympathetic Denervation as a Safe Therapeutic Option for Ventricular Arrhythmias

  • Soo Jung Park (Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University) ;
  • Deok Heon Lee (Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University) ;
  • Youngok Lee (Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University) ;
  • Hanna Jung (Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University) ;
  • Yongkeun Cho (Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University)
  • 투고 : 2023.05.03
  • 심사 : 2023.07.17
  • 발행 : 2023.11.05
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초록

Background: The recurrence of ventricular arrhythmias (VAs) in patients who have already undergone treatment with antiarrhythmic medication, catheter ablation, and the insertion of implantable cardioverter defibrillators is not uncommon. Recent studies have shown that bilateral cardiac sympathetic denervation (BCSD) effectively treats VAs. However, only a limited number of studies have confirmed the safety of BCSD as a viable therapeutic option for VAs. Methods: This single-center study included 10 patients, who had a median age of 54 years (interquartile range [IQR], 45-65 years) and a median ejection fraction of 58.5% (IQR, 56.2%-60.8%), with VAs who underwent video-assisted BCSD. BCSD was executed as a single-stage surgery for 8 patients, while the remaining 2 patients initially underwent left cardiac sympathetic denervation followed by right cardiac sympathetic denervation. We evaluated postoperative complications, the duration of hospital stays, and VA-related symptoms before and after surgery. Results: The median hospital stay after surgery was 2 days (IQR, 2-3 days). The median surgical time for BCSD was 113 minutes (IQR, 104-126 minutes). No significant complications occurred during hospitalization or after discharge. During the median follow-up period of 13.5 months (IQR, 10.5-28.0 months) from surgery, no VA-related symptoms were observed in 70% of patients. Conclusion: The benefits of a short postoperative hospitalization and negligible complications make BCSD a safe, alternative therapeutic option for patients suffering from refractory VAs.

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참고문헌

  1. Cho Y. Left cardiac sympathetic denervation: an important treatment option for patients with hereditary ventricular arrhythmias. J Arrhythm 2016;32:340-3. https://doi.org/10.1016/j.joa.2015.08.002
  2. Ertugrul I, Donmez YN, Aydin A, et al. Bilateral thoracoscopic sympathectomy for cardiac denervation in pediatric population: does Kuntz nerve cauterization have an impact on success? J Card Surg 2021;36:2705-13. https://doi.org/10.1111/jocs.15652
  3. Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. 2017 AHA/ ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Heart Rhythm 2018;15:e190-252. https://doi.org/10.1016/j.hrthm.2017.10.035
  4. Antiel RM, Bos JM, Joyce DD, et al. Quality of life after videoscopic left cardiac sympathetic denervation in patients with potentially life-threatening cardiac channelopathies/cardiomyopathies. Heart Rhythm 2016;13:62-9. https://doi.org/10.1016/j.hrthm.2015.09.001
  5. Schwartz PJ, Priori SG, Cerrone M, et al. Left cardiac sympathetic denervation in the management of high-risk patients affected by the long-QT syndrome. Circulation 2004;109:1826-33. https://doi.org/10.1161/01.CIR.0000125523.14403.1E
  6. Assis FR, Krishnan A, Zhou X, et al. Cardiac sympathectomy for refractory ventricular tachycardia in arrhythmogenic right ventricular cardiomyopathy. Heart Rhythm 2019;16:1003-10. https://doi.org/10.1016/j.hrthm.2019.01.019
  7. Assis FR, Sharma A, Shah R, et al. Long-term outcomes of bilateral cardiac sympathetic denervation for refractory ventricular tachycardia. JACC Clin Electrophysiol 2021;7:463-70. https://doi.org/10.1016/j.jacep.2021.02.003
  8. Schwartz PJ, Ackerman MJ. Cardiac sympathetic denervation in the prevention of genetically mediated life-threatening ventricular arrhythmias. Eur Heart J 2022;43:2096-102. https://doi.org/10.1093/eurheartj/ehac134
  9. Jang SY, Cho Y, Kim NK, et al. Video-assisted thoracoscopic left cardiac sympathetic denervation in patients with hereditary ventricular arrhythmias. Pacing Clin Electrophysiol 2017;40:232-41. https://doi.org/10.1111/pace.13008
  10. Ajijola OA, Vaseghi M, Mahajan A, Shivkumar K. Bilateral cardiac sympathetic denervation: why, who and when? Expert Rev Cardiovasc Ther 2012;10:947-9. https://doi.org/10.1586/erc.12.93
  11. Murtaza G, Sharma SP, Akella K, et al. Role of cardiac sympathetic denervation in ventricular tachycardia: a meta-analysis. Pacing Clin Electrophysiol 2020;43:828-37. https://doi.org/10.1111/pace.13968
  12. Tellez LJ, Garzon JC, Vinck EE, Castellanos JD. Video-assisted thoracoscopic cardiac denervation of refractory ventricular arrhythmias and electrical storms: a single-center series. J Cardiothorac Surg 2019;14:17. https://doi.org/10.1186/s13019-019-0838-6
  13. Collura CA, Johnson JN, Moir C, Ackerman MJ. Left cardiac sympathetic denervation for the treatment of long QT syndrome and catecholaminergic polymorphic ventricular tachycardia using video-assisted thoracic surgery. Heart Rhythm 2009;6:752-9. https://doi.org/10.1016/j.hrthm.2009.03.024