Left sympathetic cardiac denervation in managing electrical storm: acute outcome and long term follow up

Prabhu, Mukund A.; Bv, Srinivas; Abhilash, Sreevilasam Pushpangadhan; Thajudeen, Anees; R., Balasubramoniam K.; Namboodiri, Narayanan

doi:10.1007/s10840-016-0153-2

Cited by 13 publications

(3 citation statements)

References 16 publications

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“…Echocardiography-guided percutaneous sympathectomy is a useful alternative for patients with hemodynamic instability. 33 In the present case, sympathectomy would definitely be considered as an option in case of ablation failure.…”

Section: Discussionmentioning

confidence: 86%

My approach to ventricular tachycardia ablation in patient with arrhythmogenic right ventricular cardiomyopathy/dysplasia

Waintraub

Gandjbakhch

2020

HeartRhythm Case Reports

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Section: Discussionmentioning

confidence: 86%

My approach to ventricular tachycardia ablation in patient with arrhythmogenic right ventricular cardiomyopathy/dysplasia

Waintraub

Gandjbakhch

2020

HeartRhythm Case Reports

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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%

“…Prisma flow diagram for the study selection is shown in Figure 1. We included 14 nonrandomized studies in our final analysis 5,11‐23 . Majority of the studies were from North America.…”

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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Autonomic Regulation and Ventricular Arrhythmias

Meng¹,

Shivkumar²,

Ajijola

2018

Curr Treat Options Cardio Med

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Autonomic nervous system (ANS) has a crucial role of regulating cardiac function in the physiological state and contributes to the pathogenesis of arrhythmias in the diseased state. The cardiac neuraxis consists of multiple feedback loops consisting of efferent and afferent limbs, mediating neurotransmission to and from the heart. Efferent parasympathetic neurotransmission is mediated by the vagus nerve, while paravertebral sympathetic ganglia relay efferent sympathetic neurotransmission to the heart. The association between autonomic activity and ventricular arrhythmias (VAs) has been studied extensively in both experimental models and humans. Efferent parasympathetic activity is felt to be antiarrhythmic, while the activation of efferent sympathetic signals is proarrhythmic. The cardiac neuraxis undergoes remodeling and becomes dysfunctional in the setting of myocardial infarction (MI), chronic cardiomyopathy (CMY), and structural heat disease. Altered ANS function has been shown to initiate and/or maintain VAs via various mechanisms. Interventions targeting the ANS have been used clinically to treat VAs, particularly in patients with hereditary heart rhythm disorders and structurally abnormal hearts. Clinical applications of cardiac neuraxial modulation at the level of spinal cord, stellate ganglion, and peripheral sympathetic and vagus nerve are being developed. In this review, the anatomy of cardiac autonomic innervation, the association between autonomic activity and ventricular arrhythmogenesis, and clinical applications of neuraxial modulation in the treatment of VAs are discussed.

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Left sympathetic cardiac denervation in managing electrical storm: acute outcome and long term follow up

Cited by 13 publications

References 16 publications

My approach to ventricular tachycardia ablation in patient with arrhythmogenic right ventricular cardiomyopathy/dysplasia

My approach to ventricular tachycardia ablation in patient with arrhythmogenic right ventricular cardiomyopathy/dysplasia

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

Autonomic Regulation and Ventricular Arrhythmias

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