Surgical Cardiac Sympathetic Denervation for Ventricular Arrhythmias: A Systematic Review

Ray K. Chihara, Edward Y. Chan, Leonora M. Meisenbach, Min P. Kim

Research output: Contribution to journalArticlepeer-review

Abstract

Ventricular arrhythmias are potentially life-threatening disorders that are commonly treated with medications, catheter ablation and implantable cardioverter defibrillator (ICD). Adult patients who continue to be symptomatic, with frequent ventricular arrhythmia cardiac events or defibrillation from ICD despite medical treatment, are a challenging subgroup to manage. Surgical cardiac sympathetic denervation has emerged as a possible treatment option for people refractory to less invasive medical options. Recent treatment guidelines have recommendedcardiac sympathectomy for ventricular tachycardia (VT) or VT/fibrillation storm refractory to antiarrhythmic medications, long QT syndrome, and catecholaminergic polymorphic VT, with much of the data pertaining to pediatric literature. However, for the adult population, the disease indications, complications, and risks of cardiac sympathectomy are less understood, as are the most effective surgical cardiac denervation techniques for this patient demographic. This systematic review navigates available literature evaluating surgical denervation disease state indications, techniques, and sympathectomy risks for medically refractory ventricular arrhythmia in the adult patient population.

Original languageEnglish (US)
Pages (from-to)24-35
Number of pages12
JournalMethodist DeBakey cardiovascular journal
Volume17
Issue number1
DOIs
StatePublished - Apr 5 2021

Keywords

  • VATS
  • denervation
  • electrical storm
  • ganglion
  • ganglionectomy
  • stellate
  • stellectomy
  • sympathectomy
  • thoracoscopy
  • ventricular arrhythmias
  • ventricular fibrillation
  • ventricular tachycardia

ASJC Scopus subject areas

  • Medicine(all)

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