Cardiac sympathetic denervation for intractable ventricular arrhythmias in Chagas disease

Sáenz, Luis; Corrales, Fernando J.; Bautista, William; Traina, Mahmoud; Meymandi, Sheba; Rodríguez, Diego; Téllez, Luis Jaime; Vaseghi, Marmar; García, Fermin C.; Shivkumar, Kalyanam

doi:10.1016/j.hrthm.2016.03.014

Cited by 34 publications

(17 citation statements)

References 40 publications

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“…Sudden cardiac death caused by an arrhythmogenic event is described as the main cause of death in patients with Chagas disease in cardiac form, and several studies have searched for markers to identify patients who are at risk, including the QT dispersion (indirect marker of vagal dysautonomy) . Because there is a potential association between cardiac autonomic modulation and ventricular arrhythmia and mortality in other clinical situations, many researchers believe that abnormalities of the autonomic nervous system may have a pathophysiological role in the genesis of ventricular arrhythmias and sudden death in patients with Chagas …”

Section: Introductionmentioning

confidence: 99%

“…Also, the coexistence of denervated and innervated areas in the myocardium (that increase electrical heterogeneity) may lead to ventricular arrhythmias and sudden cardiac death. In view of the cardioprotective function of the parasympathetic system and the use of heart rate variability (HRV) as a reproducible cardiovascular autonomic function marker, the aim of the present study was to identify if there is change in the autonomic vagal modulation by HRV (with a parasympathetic maneuvers [respiratory sinus arrhythmia (RSA)] and a sympathetic stimulation [passive tilt 70°]) in patients with Chagas heart disease classified in different risk group by the score of Rassi; in this score, the sudden death occurred in 62% of the patients.…”

Section: Introductionmentioning

confidence: 99%

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Dysautonomy in different death risk groups (Rassi score) in patients with Chagas heart disease

Reis

Pereira

et al. 2018

Pacing Clinical Electrophis

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dysautonomy in different death risk groups (Rassi score) in patients with Chagas heart disease

Reis

Pereira

et al. 2018

Pacing Clinical Electrophis

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“…We included 14 nonrandomized studies in our final analysis. 5,[11][12][13][14][15][16][17][18][19][20][21][22][23] Table 2.…”

Section: Resultsmentioning

confidence: 99%

Role of cardiac sympathetic denervation in ventricular tachycardia: A meta‐analysis

Murtaza

Sharma

Akella

et al. 2020

Pacing Clinical Electrophis

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Background: Cardiac sympathetic denervation (CSD) is being used in the management of refractory ventricular tachycardia (VT) and electrical storm. However, data on the role of CSD in the management of ventricular arrhythmia is limited. Methods: We performed a meta-analysis of retrospective studies to calculate the pooled rate of freedom from VT and the standard mean difference of ICD shocks before and after CSD. Results: 14 nonrandomized studies with a total of 311 patients with refractory VT or electrical storm were included. At a mean follow up of 15 ± 10.7 months, the pooled rate of freedom from VT (VT nonrecurrence rate) after CSD in all causes of arrhythmia was 60% (range 48.8% to 70%, I 2 = 43%). When analysis was restricted to only arrhythmias caused by conditions other than catecholaminergic polymorphic ventricular tachycardia (CPVT) and long QT syndrome (LQTS), the pooled VT non-recurrence rate was 50% (range 41% to 58%, I 2 = 5%). After CSD, mean total number of ICD shocks per person diminished by 3.01 (95% CI 1.09-4.94, P = .002, I 2 = 96%) in overall analysis and by 0.97(95% CI 0.41-1.5, P = .001, I 2 = 45%) when CPVT and LQTS were excluded. Conclusion: In patients with refractory VT or electrical storm, CSD is associated with pooled VT nonrecurrence rate of 60% at a mean follow-up of 15 ± 10.7 months. CSD was also associated with significantly lower mean number ICD shocks per person. Further studies are needed to validate this finding in a prospective setting.

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“…In 2016 T ellez and Garz on would report the first cases of antiarrhythmic bilateral sympathectomies for refractory arrhythmias secondary to Chagas disease; this initial series was reported in association with the University of California, Los Angeles. 15 Table 1 shows a summary of events in the history of thoracic surgery.…”

Section: The Subspecialty In Colombiamentioning

confidence: 99%

General thoracic surgery as a subspecialty in Colombia

Vinck

2019

The Journal of Thoracic and Cardiovascular Surgery

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BRIEF HISTORY OF GENERAL THORACIC SURGERY Chest surgery has come a long way from a single costal extraction to populate the earth to a procedure that resembles a video game. Thoracic surgery has been known since ancient times, however it was not until the past century that general thoracic surgery has become a separate surgical subspecialty. As this field of surgery has evolved, so has our knowledge of diseases we treat inside the chest. 1 At the beginning of the 20th century, the field of general surgery began expanding in response to the need for expertise in different areas of surgery. During the first half of the 20th century tuberculosis was the pathology most significant to the general thoracic surgeon. With this epidemic, along with World War I-related chest injuries, a special need for surgeons knowledgeable in thoracic diseases arose. Because of this need, general surgeons would begin dedicating their practice to thoracic pathologies. 2,3 In 1909 Jacobaeus performed his famous thoracoscopy, this first important period in thoracic surgery was known as the era of enthusiasm. By 1914 tuberculosis was a worldwide pandemic and for some time it became the number one cause of death in Colombia. War and tuberculosis were the 2 main factors pivoting general thoracic from general surgery, although it was not foreign war but domestic armed conflict that required the Colombian general surgeon to start focusing on chest injuries. In 1914, Dr Pompilio Mart ınez performed the country's first cardiac suture because of a penetrating chest injury in Bogota. To answer to this new era of thoracic warfare injuries and tuberculosis, the American Association for Thoracic Surgery was created in 1917. 4-6 It is worth mentioning that the first surgery ever filmed was a general thoracic procedure by Dr Alejandro Posada in 1899 in Argentina. Because cardiovascular disease was not a major issue at this time, the need for 2 separate thoracic subspecialties was not necessary, and thus North America and Europe

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Cardiac sympathetic denervation for intractable ventricular arrhythmias in Chagas disease

Abstract: In patients with chagasic CM presenting with refractory monomorphic VT, early evidence suggests that BCSD reduces appropriate ICD therapy and may represent a valuable treatment option.

Cited by 34 publications

References 40 publications

Dysautonomy in different death risk groups (Rassi score) in patients with Chagas heart disease

Dysautonomy in different death risk groups (Rassi score) in patients with Chagas heart disease

Role of cardiac sympathetic denervation in ventricular tachycardia: A meta‐analysis

General thoracic surgery as a subspecialty in Colombia

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